Simultaneous PET/MRI assessment of response to cytotoxic and hormone neo-adjuvant chemotherapy in breast cancer: a preliminary report

V. Romeo; M. D’Aiuto; G. Frasci; M. Imbriaco; E. Nicolai

doi:10.1007/s12032-016-0876-z

Simultaneous PET/MRI assessment of response to cytotoxic and hormone neo-adjuvant chemotherapy in breast cancer: a preliminary report

V. Romeo, M. D’Aiuto, G. Frasci, M. Imbriaco, E. Nicolai

Research output: Contribution to journal › Article

Abstract

The aim of this study was to assess the response to cytotoxic and hormone neo-adjuvant chemotherapy in four patients with locally advanced breast cancer by simultaneous PET/MRI. Four patients with locally advanced breast cancer underwent simultaneous PET/MRI of the breast using a 3 T Biograph mMR before and after neo-adjuvant chemotherapy (two patients were treated with hormone-therapy and two patients were treated with cytotoxic chemotherapy). Morpho-structural tumoral features and tumor size were assessed; area value, metabolic (SUV and MTV) and functional (ADC, Ktrans, Ve, kep and iAUC) data were obtained by positioning regions of interest. A comparison of all parameters between the pre- and post-treatment PET/MRI examinations and between the two different therapeutic schedules was assessed. In patients treated with cytotoxic chemotherapy and classified as PR, there was a significant reduction of post-treatment morphological, metabolic and functional parameters. In a patient treated with hormone therapy, classified as SD, there was an increase of all post-treatment perfusion parameters, a substantially stable ADC value and a poor reduction of lesion size and of maximum SUV (SUVmax) values; the last patient, treated with hormone therapy and classified as PR, showed a significant reduction of lesion size and SUVmax values with a reduction of perfusion parameters and substantially stable ADC values. Multiparametric evaluation with simultaneous PET/MRI could be a useful tool to assess the response to cytotoxic and hormone neo-adjuvant chemotherapy in patients with breast cancer. Future studies in a larger cohort of patients are warranted to confirm the results of this preliminary study. © 2016, Springer Science+Business Media New York.

Original language	English
Journal	Medical Oncology
Volume	34
Issue number	2
DOIs	https://doi.org/10.1007/s12032-016-0876-z
Publication status	Published - Feb 2017

Keywords

Breast cancer
Neo-adjuvant chemotherapy
Simultaneous PET/MRI
cytotoxic agent
fluorodeoxyglucose f 18
hormone
antineoplastic agent
antineoplastic hormone agonists and antagonists
adult
aged
apparent diffusion coefficient
Article
breast cancer
breast carcinoma
cancer adjuvant therapy
cancer chemotherapy
cancer growth
cancer hormone therapy
cancer morphology
cancer patient
cancer size
case report
cytotoxicity
female
functional assessment
human
initial area under the concentration curve
metabolic tumor volume
middle aged
nuclear magnetic resonance imaging
oncological parameters
PET-MRI scanner
positron emission tomography
priority journal
standard uptake volume
treatment response
adjuvant chemotherapy
Breast Neoplasms
diagnostic imaging
multimodal imaging
neoadjuvant therapy
procedures
Adult
Aged
Antineoplastic Agents
Antineoplastic Agents, Hormonal
Chemotherapy, Adjuvant
Female
Humans
Magnetic Resonance Imaging
Middle Aged
Multimodal Imaging
Neoadjuvant Therapy
Positron-Emission Tomography

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Romeo, V., D’Aiuto, M., Frasci, G., Imbriaco, M., & Nicolai, E. (2017). Simultaneous PET/MRI assessment of response to cytotoxic and hormone neo-adjuvant chemotherapy in breast cancer: a preliminary report. Medical Oncology, 34(2). https://doi.org/10.1007/s12032-016-0876-z

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title = "Simultaneous PET/MRI assessment of response to cytotoxic and hormone neo-adjuvant chemotherapy in breast cancer: a preliminary report",

abstract = "The aim of this study was to assess the response to cytotoxic and hormone neo-adjuvant chemotherapy in four patients with locally advanced breast cancer by simultaneous PET/MRI. Four patients with locally advanced breast cancer underwent simultaneous PET/MRI of the breast using a 3 T Biograph mMR before and after neo-adjuvant chemotherapy (two patients were treated with hormone-therapy and two patients were treated with cytotoxic chemotherapy). Morpho-structural tumoral features and tumor size were assessed; area value, metabolic (SUV and MTV) and functional (ADC, Ktrans, Ve, kep and iAUC) data were obtained by positioning regions of interest. A comparison of all parameters between the pre- and post-treatment PET/MRI examinations and between the two different therapeutic schedules was assessed. In patients treated with cytotoxic chemotherapy and classified as PR, there was a significant reduction of post-treatment morphological, metabolic and functional parameters. In a patient treated with hormone therapy, classified as SD, there was an increase of all post-treatment perfusion parameters, a substantially stable ADC value and a poor reduction of lesion size and of maximum SUV (SUVmax) values; the last patient, treated with hormone therapy and classified as PR, showed a significant reduction of lesion size and SUVmax values with a reduction of perfusion parameters and substantially stable ADC values. Multiparametric evaluation with simultaneous PET/MRI could be a useful tool to assess the response to cytotoxic and hormone neo-adjuvant chemotherapy in patients with breast cancer. Future studies in a larger cohort of patients are warranted to confirm the results of this preliminary study. {\textcopyright} 2016, Springer Science+Business Media New York.",

keywords = "Breast cancer, Neo-adjuvant chemotherapy, Simultaneous PET/MRI, cytotoxic agent, fluorodeoxyglucose f 18, hormone, antineoplastic agent, antineoplastic hormone agonists and antagonists, adult, aged, apparent diffusion coefficient, Article, breast cancer, breast carcinoma, cancer adjuvant therapy, cancer chemotherapy, cancer growth, cancer hormone therapy, cancer morphology, cancer patient, cancer size, case report, cytotoxicity, female, functional assessment, human, initial area under the concentration curve, metabolic tumor volume, middle aged, nuclear magnetic resonance imaging, oncological parameters, PET-MRI scanner, positron emission tomography, priority journal, standard uptake volume, treatment response, adjuvant chemotherapy, Breast Neoplasms, diagnostic imaging, multimodal imaging, neoadjuvant therapy, procedures, Adult, Aged, Antineoplastic Agents, Antineoplastic Agents, Hormonal, Chemotherapy, Adjuvant, Female, Humans, Magnetic Resonance Imaging, Middle Aged, Multimodal Imaging, Neoadjuvant Therapy, Positron-Emission Tomography",

author = "V. Romeo and M. D{\textquoteright}Aiuto and G. Frasci and M. Imbriaco and E. Nicolai",

note = "Export Date: 5 March 2018 CODEN: MONCE Correspondence Address: Romeo, V.; Department of Advanced Biomedical Sciences, University Federico II of Naples, Via S. Pansini, 5, Italy; email: valeria.romeo@unina.it Chemicals/CAS: fluorodeoxyglucose f 18, 63503-12-8; Antineoplastic Agents; Antineoplastic Agents, Hormonal Tradenames: 3 T Biograph mMR, Siemens Healthcare, Germany Manufacturers: Siemens Healthcare, Germany References: Rosenkrantz, A.B., Friedman, K., Chandarana, H., Current status of hybrid PET/MRI in oncologic imaging (2016) AJR Am J Roentgenol, 206 (1), pp. 162-172. , PID: 26491894; Ho, A.M., Kalantari, B.N., PET/MRI: a new frontier in breast cancer imaging (2016) Breast J, 22 (3), pp. 261-263. , PID: 27191359; Tabouret-Viaud, C., Botsikas, D., Delattre, B.M., PET/MR in breast cancer (2015) Semin Nucl Med, 45 (4), pp. 304-321. , PID: 26050658; Margolis, N.E., Moy, L., Sigmund, E.E., Assessment of aggressiveness of breast cancer using simultaneous 18F-FDG-PET and DCE-MRI: preliminary observations (2016) Clin Nucl Med, 41 (8), pp. e355-e361. , PID: 27187730; Eiber, M., Martinez-M{\"o}ller, A., Souvatzoglou, M., Value of a Dixon-based MR/PET attenuation correction sequence for the localization and evaluation of PET-positive lesions (2011) Eur J Nucl Med Mol Imaging, 38 (9), pp. 1691-1701. , PID: 21688050; Eisenhauer, E.A., Therasse, P., Bogaerts, J., New response evaluation criteria in solid tumours; Revised RECIST guideline (version 1.1) (2009) Eur J Cancer, 45 (2), pp. 228-247. , COI: 1:STN:280:DC%2BD1M%2Fgs12rug%3D%3D, PID: 19097774; Jh, O., Lodge, M.A., Wahl, R.L., Practical PERCIST: a simplified Guide to PET response criteria in solid tumors 1.0 (2016) Radiology, 280 (2), pp. 576-584. , PID: 26909647; Tofts, P.S., Kermode, A.G., Measurement of the blood-brain barrier permeability and leakage space using dynamic MR imaging. 1. Fundamental concepts (1991) Magn Reson Med, 17 (2), pp. 357-367. , COI: 1:STN:280:DyaK3M3oslGiug%3D%3D, PID: 2062210; Tateishi, Y., Miyake, M., Nagaoka, T., Neoadjuvant chemotherapy in breast cancer: prediction of pathologic response with PET/CT and dynamic contrast-enhanced MR imaging—prospective assessment (2012) Radiology, 263 (1), pp. 53-63. , PID: 22438441; Weber, W.A., Schwaiger, M., Avril, N., Quantitative assessment of tumor metabolism using FDG-PET imaging (2000) Nucl Med Biol, 27 (7), pp. 683-687. , COI: 1:CAS:528:DC%2BD3cXot1ygsro%3D, PID: 11091112; Xu, Q.G., Xian, J.F., Role of quantitative magnetic resonance imaging parameters in the evalution of treatment response in malignant tumors (2015) Chin Med J, 128 (8), pp. 1128-1133. , PID: 25881611; Yankeelov, T.E., Lepage, M., Chakravarthy, A., Integration of quantitative DCE-MRI and ADC mapping to monitor treatment response in human breast cancer (2007) Magn Reson Imaging, 25 (1), pp. 1-13. , PID: 17222711",

year = "2017",

month = feb,

doi = "10.1007/s12032-016-0876-z",

language = "English",

volume = "34",

journal = "Medical Oncology",

issn = "1357-0560",

publisher = "Humana Press Inc.",

number = "2",

}

TY - JOUR

T1 - Simultaneous PET/MRI assessment of response to cytotoxic and hormone neo-adjuvant chemotherapy in breast cancer: a preliminary report

AU - Romeo, V.

AU - D’Aiuto, M.

AU - Frasci, G.

AU - Imbriaco, M.

AU - Nicolai, E.

N1 - Export Date: 5 March 2018 CODEN: MONCE Correspondence Address: Romeo, V.; Department of Advanced Biomedical Sciences, University Federico II of Naples, Via S. Pansini, 5, Italy; email: valeria.romeo@unina.it Chemicals/CAS: fluorodeoxyglucose f 18, 63503-12-8; Antineoplastic Agents; Antineoplastic Agents, Hormonal Tradenames: 3 T Biograph mMR, Siemens Healthcare, Germany Manufacturers: Siemens Healthcare, Germany References: Rosenkrantz, A.B., Friedman, K., Chandarana, H., Current status of hybrid PET/MRI in oncologic imaging (2016) AJR Am J Roentgenol, 206 (1), pp. 162-172. , PID: 26491894; Ho, A.M., Kalantari, B.N., PET/MRI: a new frontier in breast cancer imaging (2016) Breast J, 22 (3), pp. 261-263. , PID: 27191359; Tabouret-Viaud, C., Botsikas, D., Delattre, B.M., PET/MR in breast cancer (2015) Semin Nucl Med, 45 (4), pp. 304-321. , PID: 26050658; Margolis, N.E., Moy, L., Sigmund, E.E., Assessment of aggressiveness of breast cancer using simultaneous 18F-FDG-PET and DCE-MRI: preliminary observations (2016) Clin Nucl Med, 41 (8), pp. e355-e361. , PID: 27187730; Eiber, M., Martinez-Möller, A., Souvatzoglou, M., Value of a Dixon-based MR/PET attenuation correction sequence for the localization and evaluation of PET-positive lesions (2011) Eur J Nucl Med Mol Imaging, 38 (9), pp. 1691-1701. , PID: 21688050; Eisenhauer, E.A., Therasse, P., Bogaerts, J., New response evaluation criteria in solid tumours; Revised RECIST guideline (version 1.1) (2009) Eur J Cancer, 45 (2), pp. 228-247. , COI: 1:STN:280:DC%2BD1M%2Fgs12rug%3D%3D, PID: 19097774; Jh, O., Lodge, M.A., Wahl, R.L., Practical PERCIST: a simplified Guide to PET response criteria in solid tumors 1.0 (2016) Radiology, 280 (2), pp. 576-584. , PID: 26909647; Tofts, P.S., Kermode, A.G., Measurement of the blood-brain barrier permeability and leakage space using dynamic MR imaging. 1. Fundamental concepts (1991) Magn Reson Med, 17 (2), pp. 357-367. , COI: 1:STN:280:DyaK3M3oslGiug%3D%3D, PID: 2062210; Tateishi, Y., Miyake, M., Nagaoka, T., Neoadjuvant chemotherapy in breast cancer: prediction of pathologic response with PET/CT and dynamic contrast-enhanced MR imaging—prospective assessment (2012) Radiology, 263 (1), pp. 53-63. , PID: 22438441; Weber, W.A., Schwaiger, M., Avril, N., Quantitative assessment of tumor metabolism using FDG-PET imaging (2000) Nucl Med Biol, 27 (7), pp. 683-687. , COI: 1:CAS:528:DC%2BD3cXot1ygsro%3D, PID: 11091112; Xu, Q.G., Xian, J.F., Role of quantitative magnetic resonance imaging parameters in the evalution of treatment response in malignant tumors (2015) Chin Med J, 128 (8), pp. 1128-1133. , PID: 25881611; Yankeelov, T.E., Lepage, M., Chakravarthy, A., Integration of quantitative DCE-MRI and ADC mapping to monitor treatment response in human breast cancer (2007) Magn Reson Imaging, 25 (1), pp. 1-13. , PID: 17222711

PY - 2017/2

Y1 - 2017/2

N2 - The aim of this study was to assess the response to cytotoxic and hormone neo-adjuvant chemotherapy in four patients with locally advanced breast cancer by simultaneous PET/MRI. Four patients with locally advanced breast cancer underwent simultaneous PET/MRI of the breast using a 3 T Biograph mMR before and after neo-adjuvant chemotherapy (two patients were treated with hormone-therapy and two patients were treated with cytotoxic chemotherapy). Morpho-structural tumoral features and tumor size were assessed; area value, metabolic (SUV and MTV) and functional (ADC, Ktrans, Ve, kep and iAUC) data were obtained by positioning regions of interest. A comparison of all parameters between the pre- and post-treatment PET/MRI examinations and between the two different therapeutic schedules was assessed. In patients treated with cytotoxic chemotherapy and classified as PR, there was a significant reduction of post-treatment morphological, metabolic and functional parameters. In a patient treated with hormone therapy, classified as SD, there was an increase of all post-treatment perfusion parameters, a substantially stable ADC value and a poor reduction of lesion size and of maximum SUV (SUVmax) values; the last patient, treated with hormone therapy and classified as PR, showed a significant reduction of lesion size and SUVmax values with a reduction of perfusion parameters and substantially stable ADC values. Multiparametric evaluation with simultaneous PET/MRI could be a useful tool to assess the response to cytotoxic and hormone neo-adjuvant chemotherapy in patients with breast cancer. Future studies in a larger cohort of patients are warranted to confirm the results of this preliminary study. © 2016, Springer Science+Business Media New York.

AB - The aim of this study was to assess the response to cytotoxic and hormone neo-adjuvant chemotherapy in four patients with locally advanced breast cancer by simultaneous PET/MRI. Four patients with locally advanced breast cancer underwent simultaneous PET/MRI of the breast using a 3 T Biograph mMR before and after neo-adjuvant chemotherapy (two patients were treated with hormone-therapy and two patients were treated with cytotoxic chemotherapy). Morpho-structural tumoral features and tumor size were assessed; area value, metabolic (SUV and MTV) and functional (ADC, Ktrans, Ve, kep and iAUC) data were obtained by positioning regions of interest. A comparison of all parameters between the pre- and post-treatment PET/MRI examinations and between the two different therapeutic schedules was assessed. In patients treated with cytotoxic chemotherapy and classified as PR, there was a significant reduction of post-treatment morphological, metabolic and functional parameters. In a patient treated with hormone therapy, classified as SD, there was an increase of all post-treatment perfusion parameters, a substantially stable ADC value and a poor reduction of lesion size and of maximum SUV (SUVmax) values; the last patient, treated with hormone therapy and classified as PR, showed a significant reduction of lesion size and SUVmax values with a reduction of perfusion parameters and substantially stable ADC values. Multiparametric evaluation with simultaneous PET/MRI could be a useful tool to assess the response to cytotoxic and hormone neo-adjuvant chemotherapy in patients with breast cancer. Future studies in a larger cohort of patients are warranted to confirm the results of this preliminary study. © 2016, Springer Science+Business Media New York.

KW - Breast cancer

KW - Neo-adjuvant chemotherapy

KW - Simultaneous PET/MRI

KW - cytotoxic agent

KW - fluorodeoxyglucose f 18

KW - hormone

KW - antineoplastic agent

KW - antineoplastic hormone agonists and antagonists

KW - adult

KW - aged

KW - apparent diffusion coefficient

KW - Article

KW - breast cancer

KW - breast carcinoma

KW - cancer adjuvant therapy

KW - cancer chemotherapy

KW - cancer growth

KW - cancer hormone therapy

KW - cancer morphology

KW - cancer patient

KW - cancer size

KW - case report

KW - cytotoxicity

KW - female

KW - functional assessment

KW - human

KW - initial area under the concentration curve

KW - metabolic tumor volume

KW - middle aged

KW - nuclear magnetic resonance imaging

KW - oncological parameters

KW - PET-MRI scanner

KW - positron emission tomography

KW - priority journal

KW - standard uptake volume

KW - treatment response

KW - adjuvant chemotherapy

KW - Breast Neoplasms

KW - diagnostic imaging

KW - multimodal imaging

KW - neoadjuvant therapy

KW - procedures

KW - Adult

KW - Aged

KW - Antineoplastic Agents

KW - Antineoplastic Agents, Hormonal

KW - Chemotherapy, Adjuvant

KW - Female

KW - Humans

KW - Magnetic Resonance Imaging

KW - Middle Aged

KW - Multimodal Imaging

KW - Neoadjuvant Therapy

KW - Positron-Emission Tomography

U2 - 10.1007/s12032-016-0876-z

DO - 10.1007/s12032-016-0876-z

M3 - Article

VL - 34

JO - Medical Oncology

JF - Medical Oncology

SN - 1357-0560

IS - 2

ER -