Sequential [18F]FDG-[18F]FMISO PET and Multiparametric MRI at 3T for Insights into Breast Cancer Heterogeneity and Correlation with Patient Outcomes: First Clinical Experience
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 st...
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doaj-fd3533a41dc2465d8c86eede5e320ff52020-11-25T01:17:56ZengHindawi-WileyContrast Media & Molecular Imaging1555-43091555-43172019-01-01201910.1155/2019/13072471307247Sequential [18F]FDG-[18F]FMISO PET and Multiparametric MRI at 3T for Insights into Breast Cancer Heterogeneity and Correlation with Patient Outcomes: First Clinical ExperiencePiotr Andrzejewski0Georg Wengert1Thomas H. Helbich2Heinrich Magometschnigg3Dietmar Georg4Marcus Hacker5Pascal Baltzer6Paola Clauser7Panagiotis Kapetas8Petra Georg9Wolfgang Wadsak10Katja Pinker11Department of Radiation Oncology, Medical University of Vienna, AustriaDepartment of Biomedical Imaging and Image-guided Therapy, Molecular and Gender Imaging Medical University of Vienna, AustriaChristian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University Vienna, AustriaDepartment of Biomedical Imaging and Image-guided Therapy, Molecular and Gender Imaging Medical University of Vienna, AustriaDepartment of Radiation Oncology, Medical University of Vienna, AustriaDepartment of Biomedical Imaging and Image-guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, AustriaChristian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University Vienna, AustriaDepartment of Biomedical Imaging and Image-guided Therapy, Molecular and Gender Imaging Medical University of Vienna, AustriaDepartment of Biomedical Imaging and Image-guided Therapy, Molecular and Gender Imaging Medical University of Vienna, AustriaDepartment of Radiation Oncology, Medical University of Vienna, AustriaChristian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University Vienna, AustriaChristian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University Vienna, AustriaThe 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 diffusion-weighted imaging (DWI). Qualitative and quantitative multiparametric imaging findings were compared with pathological features (grading, proliferation, and receptor status) and clinical endpoints (recurrence/metastases and disease-specific death) using multiple correlation analysis. Histopathology was the standard of reference. There were several intermediate to strong correlations identified 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-specific 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.http://dx.doi.org/10.1155/2019/1307247 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Piotr Andrzejewski Georg Wengert Thomas H. Helbich Heinrich Magometschnigg Dietmar Georg Marcus Hacker Pascal Baltzer Paola Clauser Panagiotis Kapetas Petra Georg Wolfgang Wadsak Katja Pinker |
spellingShingle |
Piotr Andrzejewski Georg Wengert Thomas H. Helbich Heinrich Magometschnigg Dietmar Georg Marcus Hacker Pascal Baltzer Paola Clauser Panagiotis Kapetas Petra Georg Wolfgang Wadsak Katja Pinker Sequential [18F]FDG-[18F]FMISO PET and Multiparametric MRI at 3T for Insights into Breast Cancer Heterogeneity and Correlation with Patient Outcomes: First Clinical Experience Contrast Media & Molecular Imaging |
author_facet |
Piotr Andrzejewski Georg Wengert Thomas H. Helbich Heinrich Magometschnigg Dietmar Georg Marcus Hacker Pascal Baltzer Paola Clauser Panagiotis Kapetas Petra Georg Wolfgang Wadsak Katja Pinker |
author_sort |
Piotr Andrzejewski |
title |
Sequential [18F]FDG-[18F]FMISO PET and Multiparametric MRI at 3T for Insights into Breast Cancer Heterogeneity and Correlation with Patient Outcomes: First Clinical Experience |
title_short |
Sequential [18F]FDG-[18F]FMISO PET and Multiparametric MRI at 3T for Insights into Breast Cancer Heterogeneity and Correlation with Patient Outcomes: First Clinical Experience |
title_full |
Sequential [18F]FDG-[18F]FMISO PET and Multiparametric MRI at 3T for Insights into Breast Cancer Heterogeneity and Correlation with Patient Outcomes: First Clinical Experience |
title_fullStr |
Sequential [18F]FDG-[18F]FMISO PET and Multiparametric MRI at 3T for Insights into Breast Cancer Heterogeneity and Correlation with Patient Outcomes: First Clinical Experience |
title_full_unstemmed |
Sequential [18F]FDG-[18F]FMISO PET and Multiparametric MRI at 3T for Insights into Breast Cancer Heterogeneity and Correlation with Patient Outcomes: First Clinical Experience |
title_sort |
sequential [18f]fdg-[18f]fmiso pet and multiparametric mri at 3t for insights into breast cancer heterogeneity and correlation with patient outcomes: first clinical experience |
publisher |
Hindawi-Wiley |
series |
Contrast Media & Molecular Imaging |
issn |
1555-4309 1555-4317 |
publishDate |
2019-01-01 |
description |
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 diffusion-weighted imaging (DWI). Qualitative and quantitative multiparametric imaging findings were compared with pathological features (grading, proliferation, and receptor status) and clinical endpoints (recurrence/metastases and disease-specific death) using multiple correlation analysis. Histopathology was the standard of reference. There were several intermediate to strong correlations identified 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-specific 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. |
url |
http://dx.doi.org/10.1155/2019/1307247 |
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