Improved Differentiation of Benign and Malignant Breast Tumors with Multiparametric 18Fluorodeoxyglucose Positron Emission Tomography Magnetic Resonance Imaging: A Feasibility Study

Pinker, Katja; Bogner, Wolfgang; Baltzer, Pascal; Karanikas, Georgios; Magometschnigg, Heinrich; Brader, Peter; Gruber, Stephan; Bickel, Hubert; Dubsky, Peter; Bagó-Horváth, Zsuzsanna; Bartsch, Rupert; Weber, Michael; Trattnig, Siegfried; Helbich, Thomas H.

doi:10.1158/1078-0432.ccr-13-2810

Cited by 81 publications

(54 citation statements)

References 49 publications

(92 reference statements)

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“…Several patients examined in this study were previously analyzed in a different context (19,22). A prone PET/CT dataset over the breasts was acquired using a combined PET/CT in-line system (Biograph 64 TruePoint; Siemens), allowing the same patient geometry as with MRI.…”

Section: Patientsmentioning

confidence: 99%

“…Similar to MRI, PET using the radiotracer 18 F-FDG provides insight into the physiologic activity of the normal breast parenchyma through the depiction of tissue glucose metabolism (19)(20)(21)(22)(23)(24). This 18 F-FDG uptake is defined as breast parenchymal uptake (BPU).…”

mentioning

confidence: 99%

“…With the worldwide implementation of hybrid PET/MRI systems and dedicated breast PET systems, there is the potential to simultaneously assess and monitor these imaging biomarkers of breast cancer (19,25,26). To define the value of BPU, BPE, and FGT as imaging biomarkers for breast cancer and use them for better guidance of risk management decisions, information about their correlations and reproducibility is needed.…”

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confidence: 99%

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Quantitative Assessment of Breast Parenchymal Uptake on ¹⁸F-FDG PET/CT: Correlation with Age, Background Parenchymal Enhancement, and Amount of Fibroglandular Tissue on MRI

et al. 2016

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Background parenchymal enhancement (BPE), and the amount of fibroglandular tissue (FGT) assessed with MRI have been implicated as sensitive imaging biomarkers for breast cancer. The purpose of this study was to quantitatively assess breast parenchymal uptake (BPU) on 18 F-FDG PET/CT as another valuable imaging biomarker and examine its correlation with BPE, FGT, and age. Methods: This study included 129 patients with suspected breast cancer and normal imaging findings in one breast (BI-RADS 1), whose cases were retrospectively analyzed. All patients underwent prone 18 F-FDG PET/CT and 3-T contrast-enhanced MRI of the breast. In all patients, interpreter 1 assessed BPU quantitatively using SUV max . Interpreters 1 and 2 assessed amount of FGT and BPE in the normal contralateral breast by subjective visual estimation, as recommended by BI-RADS. Interpreter 1 reassessed all cases and repeated the BPU measurements. Statistical tests were used to assess correlations between BPU, BPE, FGT, and age, as well as inter-and intrainterpreter agreement. Results: BPU on 18 F-FDG PET/CT varied among patients. The mean BPU SUV max ± SD was 1.57 ± 0.6 for patients with minimal BPE, 1.93 ± 0.6 for mild BPE, 2.42 ± 0.5 for moderate BPE, and 1.45 ± 0.3 for marked BPE. There were significant (P , 0.001) moderate to strong correlations among BPU, BPE, and FGT. BPU directly correlated with both BPE and FGT on MRI. Patient age showed a moderate to strong indirect correlation with all 3 imaging-derived tissue biomarkers. The coefficient of variation for quantitative BPU measurements with SUV max was 5.6%, indicating a high reproducibility. Interinterpreter and intrainterpreter agreement for BPE and FGT was almost perfect, with a κ-value of 0.860 and 0.822, respectively. Conclusion: The results of our study demonstrate that BPU varied among patients. BPU directly correlated with both BPE and FGT on MRI, and BPU measurements were highly reproducible. Patient age showed a strong inverse correlation with all 3 imaging-derived tissue biomarkers. These findings indicate that BPU may serve as a sensitive imaging biomarker for breast cancer prediction, prognosis, and risk assessment.

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confidence: 99%

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confidence: 99%

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Quantitative Assessment of Breast Parenchymal Uptake on ¹⁸F-FDG PET/CT: Correlation with Age, Background Parenchymal Enhancement, and Amount of Fibroglandular Tissue on MRI

et al. 2016

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“…MR is very sensitive and PET may offer specificity. In a feasibility study, multi-parametric FDG-PET/MR improved the differentiation of tumor characteristics, possibly providing additional information for preoperative assessment [27]. In addition to increased spatial resolution, new and more specific markers for breast cancer are being developed in order to improve the value of FDG-PET/CT results.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of SUVmax of <sup>18</sup>F-FDG PET/CT in Early Stage Breast Cancer with No LN Metastasis

Murakami¹,

Fukushima²,

Tani³

et al. 2017

OJMI

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Purpose: To investigate the correlation between SUVmax of FDG-PET/CT and pathological findings including prognostic factors in early-stage T1-T2 breast cancer patients with no LN metastasis. Materials and Methods: This retrospective study investigated 75 patients (mean age 58.9 years; age range 30 -82 years) with invasive breast cancer who underwent FDG-PET/CT for preoperative staging. All patients underwent subsequent surgery without prior neoadjuvant chemotherapy or endocrine therapy, and those who were confirmed to have T1-or T2-stage by histopathology with no LN metastasis were included. Two patients who had no perceptible FDG accumulation on PET/CT scans were excluded. The correlations between the SUVmax of the tumor and the pathological and immunohistochemical data were evaluated. Results: The mean SUVmax for the total 73 tumors was 5.46 ± 4.05. The mean SUVmax was 3.95 ± 3.28 for the T1 stage group (n = 36) and 7.23 ± 4.10 (p < 0.001) for the T2 stage group (n = 37). A high SUVmax was significantly associated with high nuclear grade (p < 0.001), negative hormone receptor status (p < 0.001), positive HER2 status (p = 0.008), and high Ki-67 status (p < 0.001), respectively. Conclusion: In T1-T2 breast cancer with no LN metastasis, the SUVmax of FDG-PET/CT had significant positive relationships with several prognostic parameters of pathological status. Even in early-stage breast cancer patients, pretreatment FDG-PET/CT is useful for predicting malignant behavior and prognosis).

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“…Die kombinierte Anwendung dieser Parameter wird als multiparametrische Bildgebung definiert [4][5][6][7][8]. Diese ermöglicht sowohl die Erfassung der Tumormorphologie als auch die Quantifizierung und Visualisierung biologischer, physiologischer und pathologischer Prozesse auf zellulärer und molekularer Ebene, die bei der Krebsentstehung und -progression beteiligt sind.…”

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Multiparametrische und molekulare Bildgebung von Brusttumoren mit MRT und PET‑MRT

et al. 2016

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Hintergrund MRT der BrustQuantitative KM-MRT [6] erstmals die klinische Anwendbarkeit der bilateralen KM-MRT der Brust bei 7 T an Patientinnen mit Brusttumoren. Die Autoren der Studie kamen zu dem Schluss, dass die bilaterale KM-MRT der Brust bei 7 T klinisch anwendbar ist und eine Brustkrebsdiagnostik mit hoher diagnostischer Genauigkeit (96,6 %), einem ausgezeichnetem Interrateragreement und einer exzellenten Bildqualität ermöglicht. Gruber et al. [19] verglichen Bildqualität, Kontrastmittelanfärbever-halten und diagnostische Genauigkeit der bilateralen KM-MRT der Brust bei 7 und 3 T im selben Patientinnenkollektiv. Im Vergleich zu 3 T war eine signifikant bessere räumliche und zeitliche Auflösung möglich und es konnte eine exzellente Sensitivität und gute Spezifität von 100 und 91,67 % in der Brustkrebsdiagnostik erzielt werden. Diffusionsgewichtete BildgebungMit diffusionsgewichteten MR-Sequenzen("diffusion-weighted imaging", DWI) wird die zufällige Bewegung von Wassermolekülen nichtinvasiv im Gewebe gemessen. Die gemessene Diffusivität des untersuchten Gewebes stellt so einen Surrogatmarker für die Mikrostruktur und Zelldichte dar und wird durch den "apparent diffusion coefficient" (ADC)

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Improved Differentiation of Benign and Malignant Breast Tumors with Multiparametric 18Fluorodeoxyglucose Positron Emission Tomography Magnetic Resonance Imaging: A Feasibility Study

Abstract: Purpose: To assess whether multiparametric 18 fluorodeoxyglucose positron emission tomography magnetic resonance imaging (MRI) (MP 18 FDG PET-MRI) using dynamic contrast-enhanced MRI (DCE-MRI), diffusion-weighted imaging (DWI), three-dimensional proton MR spectroscopic imaging (3D

Cited by 81 publications

References 49 publications

Quantitative Assessment of Breast Parenchymal Uptake on ¹⁸F-FDG PET/CT: Correlation with Age, Background Parenchymal Enhancement, and Amount of Fibroglandular Tissue on MRI

Quantitative Assessment of Breast Parenchymal Uptake on ¹⁸F-FDG PET/CT: Correlation with Age, Background Parenchymal Enhancement, and Amount of Fibroglandular Tissue on MRI

Prognostic Value of SUVmax of <sup>18</sup>F-FDG PET/CT in Early Stage Breast Cancer with No LN Metastasis

Multiparametrische und molekulare Bildgebung von Brusttumoren mit MRT und PET‑MRT

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Improved Differentiation of Benign and Malignant Breast Tumors with Multiparametric 18Fluorodeoxyglucose Positron Emission Tomography Magnetic Resonance Imaging: A Feasibility Study

Abstract: Purpose: To assess whether multiparametric 18 fluorodeoxyglucose positron emission tomography magnetic resonance imaging (MRI) (MP 18 FDG PET-MRI) using dynamic contrast-enhanced MRI (DCE-MRI), diffusion-weighted imaging (DWI), three-dimensional proton MR spectroscopic imaging (3D

Cited by 81 publications

References 49 publications

Quantitative Assessment of Breast Parenchymal Uptake on 18F-FDG PET/CT: Correlation with Age, Background Parenchymal Enhancement, and Amount of Fibroglandular Tissue on MRI

Quantitative Assessment of Breast Parenchymal Uptake on 18F-FDG PET/CT: Correlation with Age, Background Parenchymal Enhancement, and Amount of Fibroglandular Tissue on MRI

Prognostic Value of SUVmax of &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/CT in Early Stage Breast Cancer with No LN Metastasis

Multiparametrische und molekulare Bildgebung von Brusttumoren mit MRT und PET‑MRT

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Quantitative Assessment of Breast Parenchymal Uptake on ¹⁸F-FDG PET/CT: Correlation with Age, Background Parenchymal Enhancement, and Amount of Fibroglandular Tissue on MRI

Quantitative Assessment of Breast Parenchymal Uptake on ¹⁸F-FDG PET/CT: Correlation with Age, Background Parenchymal Enhancement, and Amount of Fibroglandular Tissue on MRI

Prognostic Value of SUVmax of <sup>18</sup>F-FDG PET/CT in Early Stage Breast Cancer with No LN Metastasis