Multiparametric (18)F-FDG PET/MRI of the breast: Are there differences in imaging biomarkers of contralateral healthy tissue between patients with and without breast cancer? Journal Article


Authors: Leithner, D.; Helbich, T. H.; Bernard-Davila, B.; Marino, M. A.; Avendano, D.; Martinez, D. F.; Jochelson, M. S.; Kapetas, P.; Baltzer, P. A. T.; Haug, A.; Hacker, M.; Tanyildizi, Y.; Morris, E. A.; Pinker, K.
Article Title: Multiparametric (18)F-FDG PET/MRI of the breast: Are there differences in imaging biomarkers of contralateral healthy tissue between patients with and without breast cancer?
Abstract: The rationale was to assess whether there are differences in multiparametric 18F-FDG PET/MRI biomarkers of contralateral healthy breast tissue in patients with benign and malignant breast tumors. Methods: In this institutional review board–approved prospective single-institution study, 141 women with imaging abnormalities on mammography or sonography (BI-RADS 4/5) underwent combined 18F-FDG PET/MRI of the breast at 3T with dynamic contrast-enhanced MRI, diffusion-weighted imaging, and the radiotracer 18F-FDG. In all patients, the following imaging biomarkers were recorded for the contralateral (tumor-free) breast: breast parenchymal uptake (BPU) (from 18F-FDG PET), mean apparent diffusion coefficient (from diffusion-weighted imaging), background parenchymal enhancement (BPE), and amount of fibroglandular tissue (FGT) (from MRI). Appropriate statistical tests were used to assess differences in 18F-FDG PET/MRI biomarkers between patients with benign and malignant lesions. Results: There were 100 malignant and 41 benign lesions. BPE was minimal in 61 patients, mild in 56, moderate in 19, and marked in 5. BPE differed significantly (P < 0.001) between patients with benign and malignant lesions, with patients with cancer demonstrating decreased BPE in the contralateral tumor-free breast. FGT approached but did not reach significance (P = 0.055). BPU was 1.5 for patients with minimal BPE, 1.9 for mild BPE, 2.2 for moderate BPE, and 1.9 for marked BPE. BPU differed significantly between patients with benign lesions (mean, 1.9) and patients with malignant lesions (mean, 1.8) (P < 0.001). Mean apparent diffusion coefficient did not differ between groups (P = 0.19). Conclusion: Differences in multiparametric 18F-FDG PET/MRI biomarkers, obtained from contralateral tumor-free breast tissue, exist between patients with benign and patients with malignant breast tumors. Contralateral BPE, BPU, and FGT are decreased in breast cancer patients and may potentially serve as imaging biomarkers for the presence of malignancy. COPYRIGHT © 2020 by the Society of Nuclear Medicine and Molecular Imaging.
Keywords: adult; controlled study; aged; middle aged; major clinical study; disease marker; positron emission tomography; prospective study; breast cancer; echomammography; tumor marker; disease severity; statistical analysis; drug uptake; mammography; breast tumor; fluorodeoxyglucose f 18; colloid carcinoma; dynamic contrast-enhanced magnetic resonance imaging; diffusion weighted imaging; dynamic contrast-enhanced mri; image reconstruction; breast fibroadenoma; background parenchymal enhancement; imaging biomarker; diffusion-weighted imaging; radiological parameters; apparent diffusion coefficient; gadoterate meglumine; data system; fibroglandular tissue; very elderly; breast imaging reporting and data system; human; female; priority journal; article; breast tissue; 18f-fdg pet/mri
Journal Title: Journal of Nuclear Medicine
Volume: 61
Issue: 1
ISSN: 0161-5505
Publisher: Society of Nuclear Medicine  
Date Published: 2020-01-01
Start Page: 20
End Page: 25
Language: English
DOI: 10.2967/jnumed.119.230003
PUBMED: 31253745
PROVIDER: scopus
PMCID: PMC6954464
DOI/URL:
Notes: Article -- Export Date: 3 February 2020 -- Source: Scopus
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MSK Authors
  1. Elizabeth A Morris
    287 Morris
  2. Bianca Bernard
    21 Bernard
  3. Maria Adele Marino
    11 Marino