Amarnath Jena1, Sangeeta Taneja2, Aru Singh2, Pradeep Negi2, Shashi Bhushan Mehta2, Aashim Ahuja2, Manish Singhal3, Ramesh Sarin4. 1. Department of Molecular Imaging and Nuclear Medicine, Indraprastha Apollo Hospitals, SaritaVihar, Delhi-Mathura Road, New Delhi 110076, India. Electronic address: drjena2002@gmail.com. 2. Department of Molecular Imaging and Nuclear Medicine, Indraprastha Apollo Hospitals, SaritaVihar, Delhi-Mathura Road, New Delhi 110076, India. 3. Department of Medical Oncology, Indraprastha Apollo Hospitals, Sarita Vihar, Delhi-Mathura Road, New Delhi 110076, India. 4. Department of Surgical Oncology, Indraprastha Apollo Hospitals, Sarita Vihar, Delhi-Mathura Road, New Delhi 110076, India.
Abstract
PURPOSE: To study relationships among pharmacokinetic and 18F-fluorodeoxyglucose (18F-FDG) PET parameters obtained through simultaneous PET/MRI in breast cancer patients and evaluate their combined potential for response evaluation. METHODS: The study included 41 breast cancer patients for correlation study and 9 patients (pre and post therapy) for response evaluation. All patients underwent simultaneous PET/MRI with dedicated breast imaging. Pharmacokinetic parameters and PET parameters for tumor were derived using an in- house developed and vendor provided softwares respectively. Relationships between SUV and pharmacokinetic parameters and clinical as well as histopathologic parameters were evaluated using Spearman correlation analysis. Response to chemotherapy was derived as percentage reduction in size and in parameters post therapy. RESULTS: Significant correlations were observed between SUVmean, max, peak, TLG with Ktrans (ρ=0.446, 0.417, 0.491, 0.430; p≤0.01); with Kep(ρ=0.303, ρ=0.315, ρ=0.319; p≤0.05); and with iAUC(ρ=0.401, ρ=0.410, ρ=0.379; p≤0.05, p≤0.01). The ratio of ve/iAUC showed significant negative correlation to SUVmean, max, peak and TLG (ρ=0.420, 0.446, 0.443, 0.426; p≤0.01). Ability of SUV as well as pharmacokinetic parameters to predict response to therapy matched the RECIST criteria in 9 out of 11 lesions in 9 patients. Maximum post therapy quantitative reduction was observed in SUVpeak, TLG and Ktrans. CONCLUSION: Simultaneous PET/MRI enables illustration of close interactions between glucose metabolism and pharmacokinetic parameters in breast cancer patients and potential of their simultaneity in response assessment to therapy.
PURPOSE: To study relationships among pharmacokinetic and 18F-fluorodeoxyglucose (18F-FDG) PET parameters obtained through simultaneous PET/MRI in breast cancerpatients and evaluate their combined potential for response evaluation. METHODS: The study included 41 breast cancerpatients for correlation study and 9 patients (pre and post therapy) for response evaluation. All patients underwent simultaneous PET/MRI with dedicated breast imaging. Pharmacokinetic parameters and PET parameters for tumor were derived using an in- house developed and vendor provided softwares respectively. Relationships between SUV and pharmacokinetic parameters and clinical as well as histopathologic parameters were evaluated using Spearman correlation analysis. Response to chemotherapy was derived as percentage reduction in size and in parameters post therapy. RESULTS: Significant correlations were observed between SUVmean, max, peak, TLG with Ktrans (ρ=0.446, 0.417, 0.491, 0.430; p≤0.01); with Kep(ρ=0.303, ρ=0.315, ρ=0.319; p≤0.05); and with iAUC(ρ=0.401, ρ=0.410, ρ=0.379; p≤0.05, p≤0.01). The ratio of ve/iAUC showed significant negative correlation to SUVmean, max, peak and TLG (ρ=0.420, 0.446, 0.443, 0.426; p≤0.01). Ability of SUV as well as pharmacokinetic parameters to predict response to therapy matched the RECIST criteria in 9 out of 11 lesions in 9 patients. Maximum post therapy quantitative reduction was observed in SUVpeak, TLG and Ktrans. CONCLUSION: Simultaneous PET/MRI enables illustration of close interactions between glucose metabolism and pharmacokinetic parameters in breast cancerpatients and potential of their simultaneity in response assessment to therapy.
Authors: Amy M Fowler; Manoj Kumar; Leah Henze Bancroft; Kelley Salem; Jacob M Johnson; Jillian Karow; Scott B Perlman; Tyler J Bradshaw; Samuel A Hurley; Alan B McMillan; Roberta M Strigel Journal: Radiol Imaging Cancer Date: 2021-01-15