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Prediction of tumor differentiation using sequential PET/CT and MRI in patients with breast cancer

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Abstract

Objective

The aim of this study is to assess tumor differentiation using parameters from sequential positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) in patients with breast cancer.

Methods

This retrospective study included 78 patients with breast cancer. All patients underwent sequential PET/CT and MRI. For fluorodeoxyglucose (FDG)-PET image analysis, the maximum standardized uptake value (SUVmax) of FDG was assessed at both 1 and 2 h and metabolic tumor volume (MTV) and total lesion glycolysis (TLG). The kinetic analysis of dynamic contrast-enhanced MRI parameters was performed using dynamic enhancement curves. We assessed diffusion-weighted imaging (DWI)–MRI parameters regarding apparent diffusion coefficient (ADC) values. Histologic grades 1 and 2 were classified as low-grade, and grade 3 as high-grade tumor.

Results

Forty-five lesions of 78 patients were classified as histologic grade 3, while 26 and 7 lesions were grade 2 and grade 1, respectively. Patients with high-grade tumors showed significantly lower ADC-mean values than patients with low-grade tumors (0.99 ± 0.19 vs.1.12 ± 0.32, p = 0.007). With respect to SUVmax1, MTV2.5, and TLG2.5, patients with high-grade tumors showed higher values than patients with low-grade tumors: SUVmax1 (7.92 ± 4.5 vs.6.19 ± 3.05, p = 0.099), MTV2.5 (7.90 ± 9.32 vs.4.38 ± 5.10, p = 0.095), and TLG2.5 (40.83 ± 59.17 vs.19.66 ± 26.08, p = 0.082). However, other parameters did not reveal significant differences between low-grade and high-grade malignancies. In receiver-operating characteristic (ROC) curve analysis, ADC-mean values showed the highest area under the curve of 0.681 (95%CI 0.566–0.782) for assessing high-grade malignancy.

Conclusions

Lower ADC-mean values may predict the poor differentiation of breast cancer among diverse PET–MRI functional parameters.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea

    Joon Ho Choi, Ilhan Lim, Hansol Moon, Byung Hyun Byun, Byung Il Kim, Chang Woon Choi & Sang Moo Lim

  2. Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea

    Woo Chul Noh, Hyun-Ah Kim & Min-Ki Seong

  3. Department of Radiology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea

    Seonah Jang

  4. Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea

    Hyesil Seol

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  1. Joon Ho Choi
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Correspondence to Sang Moo Lim.

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Choi, J.H., Lim, I., Noh, W.C. et al. Prediction of tumor differentiation using sequential PET/CT and MRI in patients with breast cancer. Ann Nucl Med 32, 389–397 (2018). https://doi.org/10.1007/s12149-018-1259-7

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  • DOI: https://doi.org/10.1007/s12149-018-1259-7

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