Author/Authors :
Andrzejewski, Piotr Department of Radiation Oncology - Medical University of Vienna, Austria , Wengert, Georg Department of Biomedical Imaging and Image-guided Therapy - Molecular and Gender Imaging Medical University of Vienna, Austria , Helbich, Thomas H Department of Biomedical Imaging and Image-guided Therapy - Molecular and Gender Imaging Medical University of Vienna, Austria , Magometschnigg, Heinrich Department of Biomedical Imaging and Image-guided Therapy - Molecular and Gender Imaging Medical University of Vienna, Austria , Georg, Dietmar Department of Radiation Oncology - Medical University of Vienna, Austria , Hacker, Marcus Department of Biomedical Imaging and Image-guided Therapy - Division of Nuclear Medicine - Medical University of Vienna, Austria , Baltzer, Pascal Department of Biomedical Imaging and Image-guided Therapy - Molecular and Gender Imaging Medical University of Vienna, Austria , Clauser, Paola Department of Biomedical Imaging and Image-guided Therapy - Molecular and Gender Imaging Medical University of Vienna, Austria , Kapetas, Panagiotis Department of Biomedical Imaging and Image-guided Therapy - Molecular and Gender Imaging Medical University of Vienna, Austria , Georg, Petra Department of Radiation Oncology - Medical University of Vienna, Austria , Wadsak, Wolfgang Department of Biomedical Imaging and Image-guided Therapy - Division of Nuclear Medicine - Medical University of Vienna, Austria , Pinker, Katja Department of Biomedical Imaging and Image-guided Therapy - Molecular and Gender Imaging Medical University of Vienna, Austria
Abstract :
The aim of this study was to assess whether sequential multiparametric 18[F]fluoro-desoxy-glucose (18[F]FDG)/[18F]fluoromisonidazole ([18F]FMISO) PET-MRI in breast cancer patients is possible, facilitates information on tumor heterogeneity, and
correlates with prognostic indicators. In this pilot study, IRB-approved, prospective study, nine patients with ten suspicious breast
lesions (BIRADS 5) and subsequent breast cancer diagnosis underwent sequential combined [18F]FDG/[18F]FMISO PET-MRI.
[
18F]FDG was used to assess increased glycolysis, while [18F]FMISO was used to detect tumor hypoxia. MRI protocol included
dynamic breast contrast-enhanced MRI (DCE-MRI) and diflusion-weighted imaging (DWI). Qualitative and quantitative
multiparametric imaging ¡ndings were compared with pathological features (grading, proliferation, and receptor status) and
clinical endpoints (recurrence/metastases and disease-speci¡c death) using multiple correlation analysis. Histopathology was the
standard of reference. There were several intermediate to strong correlations identi¡ed between quantitative bioimaging markers,
histopathologic tumor characteristics, and clinical endpoints. Based on correlation analysis, multiparametric criteria provided
independent information. The prognostic indicators proliferation rate, death, and presence/development of recurrence/metastasis
correlated positively, whereas the prognostic indicator estrogen receptor status correlated negatively with PET parameters. The
strongest correlations were found between disease-speci¡c death and [18F]FDGmean (R = 0.83, p < 0.01) and between the
presence/development of metastasis and [18F]FDGmax (R = 0.79, p < 0.01), respectively. This pilot study indicates that multiparametric [18F]FDG/[18F]FMISO PET-MRI might provide complementary quantitative prognostic information on breast tumors including clinical endpoints and thus might be used to tailor treatment for precision medicine in breast cancer.
Keywords :
MRI , PET , Heterogeneity , [18F]FDG
