Abstract
Rationale: To assess whether there are differences in multiparametric 18F-fluorodeoxyglucose positron emission tomography–magnetic resonance imaging (18F-FDG PET-MRI) biomarkers of contralateral healthy breast tissue in patients with benign and malignant breast tumors. Methods: In this IRB-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 (DCE-MRI), diffusion-weighted imaging (DWI) 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 (ADCmean) (from DWI), 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 imaging biomarkers between patients with benign and malignant lesions. Results: There were 100 malignant and 41 benign lesions. BPE was minimal in 61, mild in 56, moderate in 19, and marked in 5 patients. 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 for patients with minimal BPE was 1.5, for mild BPE 1.9, for moderate BPE 2.2, and for marked BPE 1.9. BPU differed significantly between patients with benign (mean, 1.9) and malignant lesions (mean, 1.8) (P<0.001). ADCmean did not differ between groups (P = 0.19). Principal Conclusions: Differences in multiparametric 18F-FDG PET-MRI biomarkers, obtained from contralateral tumor-free breast tissue, exist between patients with benign and 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.
- Breast
- Oncology: Breast
- PET/MRI
- 18F-FDG PET-MRI
- Breast Cancer
- Diffusion-Weighted Imaging
- Dynamic Contrast-Enhanced MRI
- Imaging Biomarker
- Copyright © 2019 by the Society of Nuclear Medicine and Molecular Imaging, Inc.