The relationship between vascular and metabolic characteristics of primary breast tumours

The objective of this study was to investigate the relationship between vascular and metabolic characteristics of breast tumours in vivo, using contrast-enhanced dynamic MRI and 2-[18F] fluoro-2-deoxy-d-glucose (FDG) PET imaging. Twenty patients with large or locally advanced primary breast cancers were imaged prior to therapy. MRI data were acquired using a dynamic gradient echo sequence and analysed using two pharmacokinetic models. Static PET data were acquired in 2D mode. A significant association (P<0.05) was observed between the calculated exchange rate constants of both pharmacokinetic models and calculated PET FDG dose uptake ratios (DUR). Statistical analysis showed that the exchange rate constants can explain between 27 and 44% of the variance observed in the PET FDG uptake ratios. A relationship was demonstrated between the vascular and metabolic characteristics of primary breast tumours showing that any assessment of tumour metabolic activity using PET may be controlled at least in part by delivery of uptake agent due to the vascular characteristics of the tumour. MRI and PET provide methods of assessing breast tumour vascularity and metabolism in vivo using the exchange rate constants of dynamic MRI, and DUR of PET, respectively, these measures being related but not equivalent.

[1]  C. Kuhl,et al.  MRI of breast tumors , 2000, European Radiology.

[2]  L R Schad,et al.  Pharmacokinetic parameters in CNS Gd-DTPA enhanced MR imaging. , 1991, Journal of computer assisted tomography.

[3]  P. Tofts,et al.  Measurement of the blood‐brain barrier permeability and leakage space using dynamic MR imaging. 1. Fundamental concepts , 1991, Magnetic resonance in medicine.

[4]  A. Padhani,et al.  Assessing changes in tumour vascular function using dynamic contrast‐enhanced magnetic resonance imaging , 2002, NMR in biomedicine.

[5]  A. Rieber,et al.  Breast MRI for monitoring response of primary breast cancer to neo-adjuvant chemotherapy , 2002, European Radiology.

[6]  M. Knopp,et al.  Estimating kinetic parameters from dynamic contrast‐enhanced t1‐weighted MRI of a diffusable tracer: Standardized quantities and symbols , 1999, Journal of magnetic resonance imaging : JMRI.

[7]  Robert B Livingston,et al.  Changes in blood flow and metabolism in locally advanced breast cancer treated with neoadjuvant chemotherapy. , 2003, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[8]  Heywang-Köbrunner Sh,et al.  Contrast-enhanced magnetic resonance imaging of the breast. , 1994, Investigative radiology.

[9]  W. J. Lorenz,et al.  Pharmacokinetic Mapping of the Breast: A New Method for Dynamic MR Mammography , 1995, Magnetic resonance in medicine.

[10]  G Brix,et al.  MR mammography with pharmacokinetic mapping for monitoring of breast cancer treatment during neoadjuvant therapy. , 1994, Magnetic resonance imaging clinics of North America.

[11]  David J. Yang,et al.  Evaluation of preoperative chemotherapy using PET with fluorine-18-fluorodeoxyglucose in breast cancer. , 1996, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[12]  C. Cobelli,et al.  Glucose transport and phosphorylation in skeletal muscle in obesity: insight from a muscle-specific positron emission tomography model. , 2003, The Journal of clinical endocrinology and metabolism.

[13]  S Grootoonk,et al.  Performance Evaluation of the Positron Scanner ECAT EXACT , 1992, Journal of computer assisted tomography.

[14]  F. Gilbert,et al.  Correlation of MRI/PET rim enhancement in breast cancer: a delivery related phenomenon with therapy implications? , 2003, The Lancet. Oncology.

[15]  B. Siegel,et al.  PET in breast cancer. , 1998, Seminars in nuclear medicine.

[16]  S Yoshida,et al.  Changes in the findings of dynamic MRI by preoperative CAF chemotherapy for patients with breast cancer of stage II and III: pathologic correlation. , 1999, Oncology reports.

[17]  A. Alavi,et al.  Standardized uptake values of FDG: body surface area correction is preferable to body weight correction. , 1994, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[18]  Mathias K. Fehr,et al.  Follow-up of women with breast cancer: comparison between MRI and FDG PET , 2003, European Radiology.

[19]  R L Wahl,et al.  Metabolic monitoring of breast cancer chemohormonotherapy using positron emission tomography: initial evaluation. , 1993, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[20]  Sh. Heywang Kobrunner.  Contrast-enhanced magnetic resonance imaging of the breast , 1994 .

[21]  R. Wahl,et al.  FDG metabolism and uptake versus blood flow in women with untreated primary breast cancers , 2003, European Journal of Nuclear Medicine and Molecular Imaging.

[22]  K R Maravilla,et al.  Value of combined FDG PET and MR imaging in the evaluation of suspected recurrent local-regional breast cancer: preliminary experience. , 1999, Radiology.

[23]  Gunnar Brix,et al.  Comparison of pharmacokinetic MRI and [18F] fluorodeoxyglucose PET in the diagnosis of breast cancer: initial experience , 2001, European Radiology.

[24]  P S Tofts,et al.  Quantitative Analysis of Dynamic Gd‐DTPA Enhancement in Breast Tumors Using a Permeability Model , 1995, Magnetic resonance in medicine.

[25]  H. Weinmann,et al.  Pharmacokinetics of GdDTPA/dimeglumine after intravenous injection into healthy volunteers. , 1984, Physiological chemistry and physics and medical NMR.

[26]  Ahearn Ts.  The accuracy and robustness of dynamic contrast enhanced magnetic resonance imaging methodology. , 2003 .

[27]  M. Greco,et al.  Nuclear medicine techniques for the study of breast cancer , 1997, European Journal of Nuclear Medicine.

[28]  Robert B Livingston,et al.  Blood flow and metabolism in locally advanced breast cancer: relationship to response to therapy. , 2002, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[29]  Fiona J. Gilbert,et al.  Effect of accurate T1 calculation on pharmacokinetic analysis of primary breast cancer. , 2003 .

[30]  P F Sharp,et al.  Positron emission tomography using [(18)F]-fluorodeoxy-D-glucose to predict the pathologic response of breast cancer to primary chemotherapy. , 2000, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[31]  J. Allison,et al.  Differentiation of benign from malignant breast masses by time-intensity evaluation of contrast enhanced MRI. , 1993, Magnetic resonance imaging.