TY - JOUR
T1 - A multi-parametric PET/MRI study of breast cancer
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
Y1 - 2018/10/31
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
KW - PET/MR
KW - pharmacokinetic models
KW - shutter speed model
KW - Tofts model
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U2 - 10.1002/nbm.4026
DO - 10.1002/nbm.4026
M3 - Article
C2 - 30379384
AN - SCOPUS:85055743795
VL - 32
JO - NMR in Biomedicine
JF - NMR in Biomedicine
SN - 0952-3480
IS - 1
M1 - e4026
ER -