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Potential Clinical Applications of 18F-Fluorodeoxyglucose Positron Emission Tomography/Magnetic Resonance Mammography in Breast Cancer

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Abstract

The whole-body positron emission tomography (PET)/magnetic resonance (MR) scan is a cutting edge technology providing comprehensive structural information from MR imaging and functional features from PET in a single session. Recent research findings and clinical experience have shown that 18F-fluorodeoxyglucose (FDG) whole-body PET/MR imaging has a diagnostic performance comparable with or superior to that of PET/CT in the field of oncology, including for breast cancer. In particular, FDG PET/MR mammography in the prone position with the breast hanging in a pendant manner can provide more comprehensive information about the metabolism, anatomy, and functional features of a breast lesion than a whole-body PET/MR scan. This article reports on current state-of-the-art PET/MR mammography in patients with breast cancer and the prospects for potential application in the future.

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References

  1. Weir L, Worsley D, Bernstein V. The value of FDG positron emission tomography in the management of patients with breast cancer. Breast J. 2005;11:204–9.

    Article  PubMed  Google Scholar 

  2. Eubank WB, Mankoff DA. Evolving role of positron emission tomography in breast cancer imaging. Semin Nucl Med. 2005;35:84–99.

    Article  PubMed  Google Scholar 

  3. Lind P, Igerc I, Beyer T, Reinprecht P, Hausegger K. Advantages and limitations of FDG PET in the follow-up of breast cancer. Eur J Nucl Med Mol Imaging. 2004;31 Suppl 1:S125–34.

    PubMed  Google Scholar 

  4. Czernin J. FDG-PET in breast cancer: a different view of its clinical usefulness. Mol Imaging Biol. 2002;4:35–45.

    Article  PubMed  Google Scholar 

  5. Heusner TA, Freudenberg LS, Kuehl H, Hauth EA, Veit-Haibach P, Forsting M, et al. Whole-body PET/CT-mammography for staging breast cancer: initial results. Br J Radiol. 2008;81:743–8.

    Article  PubMed  Google Scholar 

  6. Heusner TA, Kuemmel S, Umutlu L, Koeninger A, Freudenberg LS, Hauth EA, et al. Breast cancer staging in a single session: whole-body PET/CT mammography. J Nucl Med. 2008;49:1215–22.

    Article  PubMed  Google Scholar 

  7. Huellner MW, Appenzeller P, Kuhn FP, Husmann L, Pietsch CM, Burger IA, et al. Whole-body nonenhanced PET/MR versus PET/CT in the staging and restaging of cancers: preliminary observations. Radiology. 2014;273:859–69.

    Article  PubMed  Google Scholar 

  8. Drzezga A, Souvatzoglou M, Eiber M, Beer AJ, Furst S, Martinez-Moller A, et al. First clinical experience with integrated whole-body PET/MR: comparison to PET/CT in patients with oncologic diagnoses. J Nucl Med. 2012;53:845–55.

    Article  PubMed  Google Scholar 

  9. Pace L, Nicolai E, Luongo A, Aiello M, Catalano OA, Soricelli A, et al. Comparison of whole-body PET/CT and PET/MRI in breast cancer patients: lesion detection and quantitation of 18F-deoxyglucose uptake in lesions and in normal organ tissues. Eur J Radiol. 2014;83:289–96.

    Article  PubMed  Google Scholar 

  10. Kong EJ, Chun KA, Bom HS, Lee J, Lee SJ, Cho IH. Initial experience of integrated PET/MR mammography in patients with invasive ductal carcinoma. Hell J Nucl Med. 2014;17:171–6.

    PubMed  Google Scholar 

  11. Kuhl C. The current status of breast MR imaging. Part I. Choice of technique, image interpretation, diagnostic accuracy, and transfer to clinical practice. Radiology. 2007;244:356–78.

    Article  PubMed  Google Scholar 

  12. Kuhl CK. Current status of breast MR imaging. Part 2. Clinical applications. Radiology. 2007;244:672–91.

    Article  PubMed  Google Scholar 

  13. Tellmann L, Quick HH, Bockisch A, Herzog H, Beyer T. The effect of MR surface coils on PET quantification in whole-body PET/MR: results from a pseudo-PET/MR phantom study. Med Phys. 2011;38:2795–805.

    Article  CAS  PubMed  Google Scholar 

  14. MacDonald LR, Kohlmyer S, Liu C, Lewellen TK, Kinahan PE. Effects of MR surface coils on PET quantification. Med Phys. 2011;38:2948–56.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Paulus DH, Braun H, Aklan B, Quick HH. Simultaneous PET/MR imaging: MR-based attenuation correction of local radiofrequency surface coils. Med Phys. 2012;39:4306–15.

    Article  Google Scholar 

  16. Aklan B, Paulus DH, Wenkel E, Braun H, Navalpakkam BK, Ziegler S, et al. Toward simultaneous PET/MR breast imaging: systematic evaluation and integration of a radiofrequency breast coil. Med Phys. 2013;40:024301.

    Article  PubMed  Google Scholar 

  17. Dregely I, Lanz T, Metz S, Mueller MF, Kuschan M, Nimbalkar M, et al. A 16-channel MR coil for simultaneous PET/MR imaging in breast cancer. Eur Radiol. 2015;25:1154–61.

    Article  PubMed  Google Scholar 

  18. Brendle C, Schmidt H, Oergel A, Bezrukov I, Mueller M, Schraml C, et al. Segmentation-based attenuation correction in positron emission tomography/magnetic resonance: erroneous tissue identification and its impact on positron emission tomography interpretation. Invest Radiol. 2015;50:339–46.

    Article  PubMed  Google Scholar 

  19. Keller SH, Holm S, Hansen AE, Sattler B, Andersen F, Klausen TL, et al. Image artifacts from MR-based attenuation correction in clinical, whole-body PET/MRI. MAGMA. 2013;26:173–81.

    Article  PubMed  Google Scholar 

  20. Kong E, Cho I. Clinical issues regarding misclassification by Dixon based PET/MR attenuation correction. Hell J Nucl Med. 2015;18:42–7.

    PubMed  Google Scholar 

  21. Cho I, Kong E, Chun K. Image artifacts from MR-based attenuation correction in dedicated PET/MR breast coil for PET/MR mammography. EJNMMI Phys. 2015;2:A62.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Grant AM, Deller TW, Khalighi MM, Maramraju SH, Delso G, Levin CS. NEMA NU 2-2012 performance studies for the SiPM-based ToF-PET component of the GE SIGNA PET/MR system. Med Phys. 2016;43:2334.

    Article  PubMed  Google Scholar 

  23. Biglia N, Bounous VE, Martincich L, Panuccio E, Liberale V, Ottino L, et al. Role of MRI (magnetic resonance imaging) versus conventional imaging for breast cancer presurgical staging in young women or with dense breast. Eur J Surg Oncol. 2011;37:199–204.

    Article  CAS  PubMed  Google Scholar 

  24. DeMartini W, Lehman C, Partridge S. Breast MRI for cancer detection and characterization: a review of evidence-based clinical applications. Acad Radiol. 2008;15:408–16.

    Article  PubMed  Google Scholar 

  25. Lehman CD, Isaacs C, Schnall MD, Pisano ED, Ascher SM, Weatherall PT, et al. Cancer yield of mammography, MR, and US in high-risk women: prospective multi-institution breast cancer screening study. Radiology. 2007;244:381–8.

    Article  PubMed  Google Scholar 

  26. Riedl CC, Ponhold L, Flory D, Weber M, Kroiss R, Wagner T, et al. Magnetic resonance imaging of the breast improves detection of invasive cancer, preinvasive cancer, and premalignant lesions during surveillance of women at high risk for breast cancer. Clin Cancer Res. 2007;13:6144–52.

    Article  PubMed  Google Scholar 

  27. Hylton N. Magnetic resonance imaging of the breast: opportunities to improve breast cancer management. J Clin Oncol. 2005;23:1678–84.

    Article  PubMed  Google Scholar 

  28. Lee CH. Problem solving MR imaging of the breast. Radiol Clin N Am. 2004;42:919–34. vii.

    Article  PubMed  Google Scholar 

  29. Kinkel K, Hylton NM. Challenges to interpretation of breast MRI. J Magn Reson Imaging. 2001;13:821–9.

    Article  CAS  PubMed  Google Scholar 

  30. Scheidhauer K, Walter C, Seemann MD. FDG PET and other imaging modalities in the primary diagnosis of suspicious breast lesions. Eur J Nucl Med Mol Imaging. 2004;31 Suppl 1:S70–9.

    Article  PubMed  Google Scholar 

  31. Hodgson NC, Gulenchyn KY. Is there a role for positron emission tomography in breast cancer staging? J Clin Oncol. 2008;26:712–20.

    Article  PubMed  Google Scholar 

  32. Groheux D, Espie M, Giacchetti S, Hindie E. Performance of FDG PET/CT in the clinical management of breast cancer. Radiology. 2013;266:388–405.

    Article  PubMed  Google Scholar 

  33. Kaida H, Ishibashi M, Fujii T, Kurata S, Ogo E, Tanaka M, et al. Improved detection of breast cancer on FDG-PET cancer screening using breast positioning device. Ann Nucl Med. 2008;22:95–101.

    Article  PubMed  Google Scholar 

  34. Koolen BB, Vrancken Peeters MJ, Wesseling J, Lips EH, Vogel WV, Aukema TS, et al. Association of primary tumour FDG uptake with clinical, histopathological and molecular characteristics in breast cancer patients scheduled for neoadjuvant chemotherapy. Eur J Nucl Med Mol Imaging. 2012;39:1830–8.

    Article  CAS  PubMed  Google Scholar 

  35. Moon EH, Lim ST, Han YH, Jeong YJ, Kang YH, Jeong HJ, et al. The usefulness of F-18 FDG PET/CT-mammography for preoperative staging of breast cancer: comparison with conventional PET/CT and MR-mammography. Radiol Oncol. 2013;47:390–7.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Hsu DF, Freese DL, Levin CS. Breast-dedicated radionuclide imaging systems. J Nucl Med. 2016;57 Suppl 1:40S–5S.

    Article  CAS  PubMed  Google Scholar 

  37. MacDonald L, Edwards J, Lewellen T, Haseley D, Rogers J, Kinahan P. Clinical imaging characteristics of the positron emission mammography camera: PEM Flex Solo II. J Nucl Med. 2009;50:1666–75.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Kalinyak JE, Berg WA, Schilling K, Madsen KS, Narayanan D, Tartar M. Breast cancer detection using high-resolution breast PET compared to whole-body PET or PET/CT. Eur J Nucl Med Mol Imaging. 2014;41:260–75.

    Article  PubMed  Google Scholar 

  39. Berg WA, Madsen KS, Schilling K, Tartar M, Pisano ED, Larsen LH, et al. Breast cancer: comparative effectiveness of positron emission mammography and MR imaging in presurgical planning for the ipsilateral breast. Radiology. 2011;258:59–72.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Moy L, Noz ME, Maguire Jr GQ, Melsaether A, Deans AE, Murphy-Walcott AD, et al. Role of fusion of prone FDG-PET and magnetic resonance imaging of the breasts in the evaluation of breast cancer. Breast J. 2010;16:369–76.

    PubMed  Google Scholar 

  41. Taneja S, Jena A, Goel R, Sarin R, Kaul S. Simultaneous whole-body 18F-FDG PET-MRI in primary staging of breast cancer: a pilot study. Eur J Radiol. 2014;83:2231–9.

    Article  PubMed  Google Scholar 

  42. Botsikas D, Kalovidouri A, Becker M, Copercini M, Djema DA, Bodmer A, et al. Clinical utility of 18F-FDG-PET/MR for preoperative breast cancer staging. Eur Radiol. 2015;26:2297-307.

  43. Grueneisen J, Nagarajah J, Buchbender C, Hoffmann O, Schaarschmidt BM, Poeppel T, et al. Positron emission tomography/magnetic resonance imaging for local tumor staging in patients with primary breast cancer: a comparison with positron emission tomography/computed tomography and magnetic resonance imaging. Invest Radiol. 2015;50:505–13.

    Article  CAS  PubMed  Google Scholar 

  44. Crippa F, Gerali A, Alessi A, Agresti R, Bombardieri E. FDG-PET for axillary lymph node staging in primary breast cancer. Eur J Nucl Med Mol Imaging. 2004;31 Suppl 1:S97–102.

    Article  PubMed  Google Scholar 

  45. Lovrics PJ, Chen V, Coates G, Cornacchi SD, Goldsmith CH, Law C, et al. A prospective evaluation of positron emission tomography scanning, sentinel lymph node biopsy, and standard axillary dissection for axillary staging in patients with early stage breast cancer. Ann Surg Oncol. 2004;11:846–53.

    Article  PubMed  Google Scholar 

  46. Riegger C, Koeninger A, Hartung V, Otterbach F, Kimmig R, Forsting M, et al. Comparison of the diagnostic value of FDG-PET/CT and axillary ultrasound for the detection of lymph node metastases in breast cancer patients. Acta Radiol. 2012;53:1092–8.

    Article  PubMed  Google Scholar 

  47. Aukema TS, Straver ME, Peeters MJ, Russell NS, Gilhuijs KG, Vogel WV, et al. Detection of extra-axillary lymph node involvement with FDG PET/CT in patients with stage II-III breast cancer. Eur J Cancer. 2010;46:3205–10.

    Article  PubMed  Google Scholar 

  48. Abramson RG, Lambert KF, Jones-Jackson LB, Arlinghaus LR, Williams J, Abramson VG, et al. Prone versus supine breast FDG-PET/CT for assessing locoregional disease distribution in locally advanced breast cancer. Acad Radiol. 2015;22:853–9.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Koolen BB, Valdes Olmos RA, Elkhuizen PH, Vogel WV, Vrancken Peeters MJ, Rodenhuis S, et al. Locoregional lymph node involvement on 18F-FDG PET/CT in breast cancer patients scheduled for neoadjuvant chemotherapy. Breast Cancer Res Treat. 2012;135:231–40.

    Article  PubMed  Google Scholar 

  50. He N, Xie C, Wei W, Pan C, Wang W, Lv N, et al. A new, preoperative, MRI-based scoring system for diagnosing malignant axillary lymph nodes in women evaluated for breast cancer. Eur J Radiol. 2012;81:2602–12.

    Article  PubMed  Google Scholar 

  51. Chia S, Swain SM, Byrd DR, Mankoff DA. Locally advanced and inflammatory breast cancer. J Clin Oncol. 2008;26:786–90.

    Article  PubMed  Google Scholar 

  52. Rastogi P, Anderson SJ, Bear HD, Geyer CE, Kahlenberg MS, Robidoux A, et al. Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27. J Clin Oncol. 2008;26:778–85.

    Article  PubMed  Google Scholar 

  53. Fisher ER, Wang J, Bryant J, Fisher B, Mamounas E, Wolmark N. Pathobiology of preoperative chemotherapy: findings from the National Surgical Adjuvant Breast and Bowel (NSABP) protocol B-18. Cancer. 2002;95:681–95.

    Article  PubMed  Google Scholar 

  54. Avril S, Muzic Jr RF, Plecha D, Traughber BJ, Vinayak S, Avril N. 18F-FDG PET/CT for monitoring of treatment response in breast cancer. J Nucl Med. 2016;57 Suppl 1:34S–9S.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Lobbes MB, Prevos R, Smidt M, Tjan-Heijnen VC, van Goethem M, Schipper R, et al. The role of magnetic resonance imaging in assessing residual disease and pathologic complete response in breast cancer patients receiving neoadjuvant chemotherapy: a systematic review. Insights Imaging. 2013;4:163–75.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Park SH, Moon WK, Cho N, Chang JM, Im SA, Park IA, et al. Comparison of diffusion-weighted MR imaging and FDG PET/CT to predict pathological complete response to neoadjuvant chemotherapy in patients with breast cancer. Eur Radiol. 2012;22:18–25.

    Article  PubMed  Google Scholar 

  57. An YY, Kim SH, Kang BJ, Lee AW. Treatment response evaluation of breast cancer after neoadjuvant chemotherapy and usefulness of the imaging parameters of MRI and PET/CT. J Korean Med Sci. 2015;30:808–15.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Charles-Edwards EM, DeSouza NM. Diffusion-weighted magnetic resonance imaging and its application to cancer. Cancer Imaging. 2006;6:135–43.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Thoeny HC, De Keyzer F. Extracranial applications of diffusion-weighted magnetic resonance imaging. Eur Radiol. 2007;17:1385–93.

    Article  PubMed  Google Scholar 

  60. Guo Y, Cai YQ, Cai ZL, Gao YG, An NY, Ma L, et al. Differentiation of clinically benign and malignant breast lesions using diffusion-weighted imaging. J Magn Reson Imaging. 2002;16:172–8.

    Article  PubMed  Google Scholar 

  61. Kuroki Y, Nasu K, Kuroki S, Murakami K, Hayashi T, Sekiguchi R, et al. Diffusion-weighted imaging of breast cancer with the sensitivity encoding technique: analysis of the apparent diffusion coefficient value. Magn Reson Med Sci. 2004;15:79–85.

    Article  Google Scholar 

  62. Razek AA, Gaballa G, Denewer A, Nada N. Invasive ductal carcinoma: correlation of apparent diffusion coefficient value with pathological prognostic factors. NMR Biomed. 2010;23:619–23.

    Article  PubMed  Google Scholar 

  63. Martincich L, Deantoni V, Bertotto I, Redana S, Kubatzki F, Sarotto I, et al. Correlations between diffusion-weighted imaging and breast cancer biomarkers. Eur Radiol. 2012;22:1519–28.

    Article  PubMed  Google Scholar 

  64. Kim SH, Cha ES, Kim HS, Kang BJ, Choi JJ, Jung JH, et al. Diffusion-weighted imaging of breast cancer: correlation of the apparent diffusion coefficient value with prognostic factors. J Magn Reson Imaging. 2009;30:615–20.

    Article  PubMed  Google Scholar 

  65. Youk JH, Son EJ, Chung J, Kim JA, Kim EK. Triple-negative invasive breast cancer on dynamic contrast-enhanced and diffusion-weighted MR imaging: comparison with other breast cancer subtypes. Eur Radiol. 2012;22:1724–34.

    Article  PubMed  Google Scholar 

  66. Choi BB, Kim SH, Kang BJ, Lee JH, Song BJ, Jeong SH, et al. Diffusion-weighted imaging and FDG PET/CT: predicting the prognoses with apparent diffusion coefficient values and maximum standardized uptake values in patients with invasive ductal carcinoma. World J Surg Oncol. 2012;10:126.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Baba S, Isoda T, Maruoka Y, Kitamura Y, Sasaki M, Yoshida T, et al. Diagnostic and prognostic value of pretreatment SUV in 18F-FDG/PET in breast cancer: comparison with apparent diffusion coefficient from diffusion-weighted MR imaging. J Nucl Med. 2014;55:736–42.

    Article  CAS  PubMed  Google Scholar 

  68. Kong E, Chun KA, Bae YK, Cho IH. Integrated PET/MR mammography for quantitative analysis and correlation to prognostic factors of invasive ductal carcinoma. Q J Nucl Med Mol Imaging. 2016. In press.

  69. Belkic D, Belkic K. Molecular imaging in the framework of personalized cancer medicine. Isr Med Assoc J. 2013;15:665–72.

    PubMed  Google Scholar 

  70. Cho N, Im SA, Kang KW, Park IA, Song IC, Lee KH, et al. Early prediction of response to neoadjuvant chemotherapy in breast cancer patients: comparison of single-voxel (1)H-magnetic resonance spectroscopy and (18)F-fluorodeoxyglucose positron emission tomography. Eur Radiol. 2016;26:2279-90.

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  1. Department of Nuclear Medicine, Yeugnam University Hospital, 317-1, Daemyung-dong,Nam-gu, Daegu, 705-717, Republic of Korea

    Ihn-Ho Cho & Eun-Jung Kong

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Ihn-ho Cho and Eung-Jung Kong declare that they have no conflict of interest.

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The study was approved by an institutional review board or equivalent and has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All subjects in the study gave written informed consent or the institutional review board waived the need to obtain informed consent.

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Cho, IH., Kong, EJ. Potential Clinical Applications of 18F-Fluorodeoxyglucose Positron Emission Tomography/Magnetic Resonance Mammography in Breast Cancer. Nucl Med Mol Imaging 51, 217–226 (2017). https://doi.org/10.1007/s13139-016-0446-5

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