Correlation between F-18 fluorodeoxyglucose PET metabolic parameters and dynamic contrast-enhanced MRI-derived perfusion data in patients with invasive ductal breast carcinoma

Objectives We sought relationships among the metabolic and vascular characteristics of breast cancer using dynamic contrast-enhanced (DCE)-MRI and F-18 fluorodeoxyglucose (FDG) PET/CT imaging.

Methods Sixty-seven female patients with invasive ductal breast carcinoma (age 32-79 years) who underwent FDG PET/CT and DCE-MRI prior to cancer treatment, were included. The maximum SUV (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and the heterogeneity factor (HF), were derived from FDG PET/CT. The DCE-MRI parameters Ktrans, Kep, and Ve were obtained for all tumors, and relationships between the metabolic and perfusion parameters were sought via Spearman’s rank correlation analysis. The prognostic significance of clinicopathological and imaging parameters in terms of recurrence-free survival (RFS) was also evaluated.

Results We found no significant correlation between perfusion and metabolic parameters (p>0.05), except between SUVmax and Ve (p=0.001, rho= -0.391, table). Recurrence developed in 12 of the 67 patients (17.9%, follow-up period: 8-41 months). Age (p=0.016) and the HF (p=0.027) were significant independent predictors of relapse-free survival (RFS) upon multivariate analysis. The RFS of patients under 40 years of age was significantly poorer than that of older patients (p<0.001). Survival of the low-HF group (HF<-0.12) was poorer than that of the high-HF group (p=0.033).

Conclusions We found that tumors with higher levels of glucose metabolism (SUVmax values) exhibited higher tumor cellularities (Ve values). Also we suggested that, of the various metabolic and perfusion parameters available, tumor heterogeneity measured via FDG PET/CT (HF) may be useful to predict RFS in breast cancer patients.