HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mankoff, D. A. Articles by Livingston, R. B. Search for Related Content PubMed PubMed Citation Articles by Mankoff, D. A. Articles by Livingston, R. B.

Blood Flow and Metabolism in Locally Advanced Breast Cancer: Relationship to Response to Therapy

¹ Division of Nuclear Medicine, University of Washington, Seattle, Washington
² Division of Medical Oncology, University of Washington, Seattle, Washington
³ Department of Pathology, University of Washington, Seattle, Washington

View larger version (16K): [in a new window]   FIGURE 1. Primary tumor, normal (Nl) breast, and LV blood time–activity curves from sample patient with metabolically active tumor after injection of 15O-water (A) and 18F-FDG (B). Y-axis units are arbitrary units of radioactivity that are same for both plots. Curves have been corrected for radioactive decay. Y-axis and x-axis scales are different.

View larger version (16K): [in a new window]   FIGURE 2. Example of model estimation of blood flow and metabolic rate. (A) Compartmental model fits of tumor and tissue time–activity curves. Lack of smoothness in fit curve (tumor fit and normal [Nl] breast fit) results from lack of smoothing of blood time–activity curve, which serves as input to model, before use in model. (B) Graphic analysis plot for tumor and Nl breast shows line fits for data from 30 to 60 min after injection. Y-axis is normalized activity, which is tissue activity/blood activity. X-axis is normalized time, which is integrated blood activity/blood activity. 18F-FDG flux constant is estimated from slope of line fit (tumor fit and Nl breast fit).

View larger version (10K): [in a new window]   FIGURE 3. PET parameter estimate values for tumor vs. normal breast: blood flow (A), water distribution volume (Vd) (B), and metabolism (MRFDG) (C).

View larger version (18K): [in a new window]   FIGURE 4. Correlation between PET parameter estimates of MRFDG and flow.

View larger version (12K): [in a new window]   FIGURE 5. PET parameter estimates vs. pathologic response to neoadjuvant chemotherapy (NR, PR, or CR): blood flow (A), MRFDG (B), and MRFDG/blood flow (C).

View larger version (24K): [in a new window]   FIGURE 6. Kaplan–Meier plot of disease-free survival for patients with MRFDG/flow < median (top line) vs. patients with MRFDG/flow > median (bottom line) shows that patients with higher MRFDG-to-flow ratio have poorer disease-free survival. Probability value for difference in curves by Wilcoxon statistic is 0.09. Probability value for association between survival and MRFDG/flow by Cox proportional hazards model, which takes better advantage of continuous nature of PET data, is 0.05.

View larger version (75K): [in a new window]   FIGURE 7. Thick sagittal PET images: summed FDG image (top) and summed water image (bottom). Tumor activity is indicated by open arrow, and cardiac activity is indicated by solid arrow. Comparison suggests flow–metabolism mismatch at center of tumor, with comparatively less blood flow in center than periphery of tumor.