A multi-parametric PET/MRI study of breast cancer: Evaluation of DCE-MRI pharmacokinetic models and correlation with diffusion and functional parameters

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Abstract

The objective of this study is to compare perfusion parameters, as measured by the shutter speed and the Tofts models applied in DCE-MRI, in malignant breast lesions. Also, to investigate the relationship between perfusion, morphological and functional parameters extracted by the simultaneous acquisition of positron emission tomography (PET) and MRI. 46 patients with histologically confirmed breast cancer were imaged with a 3 T hybrid PET/MRI system, at staging. 18F-fluorodeoxyglucose (FDG) PET images were acquired simultaneously with MRI, which included DW- and DCE-MRI. Standardized uptake value (SUV), apparent diffusion coefficient (ADC) and pharmacokinetic maps (from the Tofts and shutter speed models) were generated for each primary lesion and a reference, healthy tissue area. Wilcoxon and Spearman tests were used for the statistical analysis. MRI-derived parameters (perfusion and diffusion) and PET SUVmean were significantly different between tumour and reference tissue (p < 0.05). Significant correlations were found between the two pharmacokinetic models (p < 0.01) and between SUV and pharmacokinetic parameters (Ktrans, kep, ve and τi). No correlation was observed between ADC and SUV, or between ADC and pharmacokinetic parameters. In conclusion, PET/MRI allows for the characterization of primary lesions in breast cancer. Simultaneous analysis of perfusion, morphological and functional markers reveals good agreement between different pharmacokinetic models. Perfusion parameters showed a good correlation with the SUV in breast lesions. In particular, the shutter speed τi was found to be significantly correlated to 18F-FDG uptake (negative correlation), indicating an association with tumour metabolic mechanisms.

Original languageEnglish
Article numbere4026
JournalNMR in Biomedicine
Volume32
Issue number1
DOIs
Publication statusE-pub ahead of print - Oct 31 2018

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Positron emission tomography
Pharmacokinetics
Positron-Emission Tomography
Magnetic resonance imaging
Perfusion
Breast Neoplasms
Fluorodeoxyglucose F18
Breast
Tumors
Tissue
Neoplasms
Statistical methods

Keywords

  • breast cancer
  • DCE-MRI
  • diffusion imaging
  • PET/MR
  • pharmacokinetic models
  • shutter speed model
  • Tofts model

ASJC Scopus subject areas

  • Molecular Medicine
  • Radiology Nuclear Medicine and imaging
  • Spectroscopy

Cite this

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title = "A multi-parametric PET/MRI study of breast cancer: Evaluation of DCE-MRI pharmacokinetic models and correlation with diffusion and functional parameters",
abstract = "The objective of this study is to compare perfusion parameters, as measured by the shutter speed and the Tofts models applied in DCE-MRI, in malignant breast lesions. Also, to investigate the relationship between perfusion, morphological and functional parameters extracted by the simultaneous acquisition of positron emission tomography (PET) and MRI. 46 patients with histologically confirmed breast cancer were imaged with a 3 T hybrid PET/MRI system, at staging. 18F-fluorodeoxyglucose (FDG) PET images were acquired simultaneously with MRI, which included DW- and DCE-MRI. Standardized uptake value (SUV), apparent diffusion coefficient (ADC) and pharmacokinetic maps (from the Tofts and shutter speed models) were generated for each primary lesion and a reference, healthy tissue area. Wilcoxon and Spearman tests were used for the statistical analysis. MRI-derived parameters (perfusion and diffusion) and PET SUVmean were significantly different between tumour and reference tissue (p < 0.05). Significant correlations were found between the two pharmacokinetic models (p < 0.01) and between SUV and pharmacokinetic parameters (Ktrans, kep, ve and τi). No correlation was observed between ADC and SUV, or between ADC and pharmacokinetic parameters. In conclusion, PET/MRI allows for the characterization of primary lesions in breast cancer. Simultaneous analysis of perfusion, morphological and functional markers reveals good agreement between different pharmacokinetic models. Perfusion parameters showed a good correlation with the SUV in breast lesions. In particular, the shutter speed τi was found to be significantly correlated to 18F-FDG uptake (negative correlation), indicating an association with tumour metabolic mechanisms.",
keywords = "breast cancer, DCE-MRI, diffusion imaging, PET/MR, pharmacokinetic models, shutter speed model, Tofts model",
author = "Marianna Inglese and Carlo Cavaliere and Serena Monti and Ernesto Forte and Mariarosaria Incoronato and Emanuele Nicolai and Marco Salvatore and Marco Aiello",
year = "2018",
month = "10",
day = "31",
doi = "10.1002/nbm.4026",
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T2 - Evaluation of DCE-MRI pharmacokinetic models and correlation with diffusion and functional parameters

AU - Inglese, Marianna

AU - Cavaliere, Carlo

AU - Monti, Serena

AU - Forte, Ernesto

AU - Incoronato, Mariarosaria

AU - Nicolai, Emanuele

AU - Salvatore, Marco

AU - Aiello, Marco

PY - 2018/10/31

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N2 - The objective of this study is to compare perfusion parameters, as measured by the shutter speed and the Tofts models applied in DCE-MRI, in malignant breast lesions. Also, to investigate the relationship between perfusion, morphological and functional parameters extracted by the simultaneous acquisition of positron emission tomography (PET) and MRI. 46 patients with histologically confirmed breast cancer were imaged with a 3 T hybrid PET/MRI system, at staging. 18F-fluorodeoxyglucose (FDG) PET images were acquired simultaneously with MRI, which included DW- and DCE-MRI. Standardized uptake value (SUV), apparent diffusion coefficient (ADC) and pharmacokinetic maps (from the Tofts and shutter speed models) were generated for each primary lesion and a reference, healthy tissue area. Wilcoxon and Spearman tests were used for the statistical analysis. MRI-derived parameters (perfusion and diffusion) and PET SUVmean were significantly different between tumour and reference tissue (p < 0.05). Significant correlations were found between the two pharmacokinetic models (p < 0.01) and between SUV and pharmacokinetic parameters (Ktrans, kep, ve and τi). No correlation was observed between ADC and SUV, or between ADC and pharmacokinetic parameters. In conclusion, PET/MRI allows for the characterization of primary lesions in breast cancer. Simultaneous analysis of perfusion, morphological and functional markers reveals good agreement between different pharmacokinetic models. Perfusion parameters showed a good correlation with the SUV in breast lesions. In particular, the shutter speed τi was found to be significantly correlated to 18F-FDG uptake (negative correlation), indicating an association with tumour metabolic mechanisms.

AB - The objective of this study is to compare perfusion parameters, as measured by the shutter speed and the Tofts models applied in DCE-MRI, in malignant breast lesions. Also, to investigate the relationship between perfusion, morphological and functional parameters extracted by the simultaneous acquisition of positron emission tomography (PET) and MRI. 46 patients with histologically confirmed breast cancer were imaged with a 3 T hybrid PET/MRI system, at staging. 18F-fluorodeoxyglucose (FDG) PET images were acquired simultaneously with MRI, which included DW- and DCE-MRI. Standardized uptake value (SUV), apparent diffusion coefficient (ADC) and pharmacokinetic maps (from the Tofts and shutter speed models) were generated for each primary lesion and a reference, healthy tissue area. Wilcoxon and Spearman tests were used for the statistical analysis. MRI-derived parameters (perfusion and diffusion) and PET SUVmean were significantly different between tumour and reference tissue (p < 0.05). Significant correlations were found between the two pharmacokinetic models (p < 0.01) and between SUV and pharmacokinetic parameters (Ktrans, kep, ve and τi). No correlation was observed between ADC and SUV, or between ADC and pharmacokinetic parameters. In conclusion, PET/MRI allows for the characterization of primary lesions in breast cancer. Simultaneous analysis of perfusion, morphological and functional markers reveals good agreement between different pharmacokinetic models. Perfusion parameters showed a good correlation with the SUV in breast lesions. In particular, the shutter speed τi was found to be significantly correlated to 18F-FDG uptake (negative correlation), indicating an association with tumour metabolic mechanisms.

KW - breast cancer

KW - DCE-MRI

KW - diffusion imaging

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KW - pharmacokinetic models

KW - shutter speed model

KW - Tofts model

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