本研究的目的是评估扩散加权全身磁共振成像（WBMRI）在高风险转移的乳腺癌的初期分期中与正电子发射断层扫描（PET-CT）相比的效果。本研究纳入了45名女性患者。纳入标准包括女性，年龄大于18岁，浸润性乳腺癌，初期PET-CT和0-2级的活动状态。排除标准包括WB-MRI禁忌症和乳腺癌复发。主要观察指标是WB-MRI和PET-CT在诊断远处转移方面的一致性，次要观察指标包括一致性在原发肿瘤和区域淋巴结（LN）的诊断中，以及两名放射科医生对WB-MRI解释的一致性。平均年龄为51.2岁，原发肿瘤的中位数大小为30毫米。两种检查方法在转移分期方面的一致性几乎完美（k = 0.862），放射科医生之间的一致性非常好。WB-MRI检测区域LN、远程LN、肺、肝或骨转移的准确度在91%至96%之间。两例病例中，WB-MRI检测到PET-CT忽视的骨转移。WB-MRI在分期原发肿瘤、区域LN状态和分期方面与PET-CT显示了相当的一致性（k = 0.766, k = 0.756和k = 0.785），且放射科医生之间的一致性很高。WBMRI包括扩散加权成像可作为乳腺癌高风险转移患者初期分期中可靠且可重复的检查，特别是对于骨转移，因此可作为PET-CT的替代检查。扩散加权全身磁共振成像是一种有前景的技术，用于检测初期高风险乳腺癌的转移。与PET-CT相比，扩散加权全身磁共振成像（WBMRI）在与45例高风险转移乳腺癌患者的初期分期中检测转移方面是有效的。WB-MRI与PET-CT在转移分期方面的一致性几乎完美，放射科医生之间的一致性非常好。WB-MRI检测骨转移的准确率为92%。© 2023. 作者（们），独家许可欧洲放射学学会。

The aim of this study was to assess the diffusion-weighted whole-body-MRI (WBMRI) in the initial staging of breast cancer at high risk of metastases in comparison with positron emission tomography (PET)-CT.Forty-five women were prospectively enrolled. The inclusion criteria were female gender, age >18, invasive breast cancer, an initial PET-CT, and a performance status of 0-2. The exclusion criteria were contraindication to WB-MRI and breast cancer recurrence. The primary outcome was the concordance of WB-MRI and PET-CT in the diagnosis of distant metastases, whereas secondary outcomes included their concordance for the primary tumor and regional lymph nodes (LN), as well as the agreement of WB-MRI interpretation between two radiologists.The mean age was 51.2 years with a median size of the primary tumor of 30 mm. Concordance between the two modalities was almost perfect for metastases staging, all sites included (k = 0.862), with excellent interobserver agreement. The accuracy of WB-MRI for detecting regional LN, distant LN, lung, liver, or bone metastases ranged from 91 to 96%. In 2 patients, WB-MRI detected bone metastases that were overlooked by PET-CT. WB-MRI showed a substantial agreement with PET-CT for staging the primary tumor, regional LN status, and stage (k = 0.766, k = 0.756, and k = 0.785, respectively) with a high interobserver agreement.WB-MRI including DWI could be a reliable and reproducible examination in the initial staging of breast cancer patients at high risk of metastases, especially for bone metastases and therefore could be used as a surrogate to PET-CT.Whole-body-MRI including DWI is a promising technique for detecting metastases in the initial staging of breast cancer at high risk of metastases.Whole-body-MRI (WB-MRI) was effective for detecting metastases in the initial staging of 45 breast cancer patients at high risk of metastases in comparison with PET-CT. Concordance between WB-MRI and PET-CT was almost perfect for metastases staging, all sites included, with excellent interobserver agreement. The accuracy of WB-MRI for detecting bone metastases was 92%.© 2023. The Author(s), under exclusive licence to European Society of Radiology.