Does breast MRI background parenchymal enhancement indicate metabolic activity? Qualitative and 3D quantitative computer imaging analysis

Abstract

3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:753-759.

Multiparametric 18F-FDG PET/MRI of the Breast: Are There Differences in Imaging Biomarkers of Contralateral Healthy Tissue Between Patients With and Without Breast Cancer?

“…From December 2009 to November 2014, 191 consecutive patients who fulfilled the following criteria were included in this study: at least 18 y old, not pregnant, not breastfeeding, imaging abnormality on mammography or sonography (Breast Imaging Reporting and Data System [BI-RADS] 4, suspicious abnormality; 5, highly suggestive for malignancy), and no contraindications to MRI or contrast agents. All patients underwent combined multiparametric 18 F-FDG PET/MRI of the breast at 3 T. Exclusion criteria were incomplete examinations (n 5 6), previous treatment (n 5 8), and tumor of the contralateral breast (BI-RADS 2-5) (n 5 36). All lesions were histopathologically verified after 18 F-FDG PET/CT and MRI by surgical or image-guided biopsy.…”

“…All patients underwent combined multiparametric 18 F-FDG PET/MRI of the breast at 3 T. Exclusion criteria were incomplete examinations (n 5 6), previous treatment (n 5 8), and tumor of the contralateral breast (BI-RADS 2-5) (n 5 36). All lesions were histopathologically verified after 18 F-FDG PET/CT and MRI by surgical or image-guided biopsy. Thus, 141 patients (140 female; mean age, 57 6 14.3 y; range, 18-86 y) with a tumor-free contralateral breast on mammography, ultrasound, MRI, and 18 F-FDG PET/MRI (BI-RADS 1) were included in this retrospective analysis.…”

“…Like MRI, PET using the radiotracer 18 F-FDG provides information on tissue glucose metabolism and, hence, the physiologic activity of breast parenchyma (17). FGT shows varying degrees of 18 F-FDG uptake, that is, breast parenchymal uptake (BPU), which correlates with both BPE and FGT (17,18) and therefore might also serve as another important imaging biomarker in breast cancer.…”

“…Hybrid PET/MRI scanners, now being increasingly used (19)(20)(21), can simultaneously assess and spatiolongitudinally monitor these multiple imaging biomarkers and could therefore significantly contribute to risk-adapted screening and risk-reduction strategies in clinical practice. The aim of our study was to assess whether there may be differences in multiparametric 18 F-FDG PET/MRI biomarkers of contralateral healthy breast tissue between patients with benign and patients with malignant breast tumors.…”

Comparison between qualitative and quantitative assessment of background parenchymal enhancement on breast MRI

“…These inconsistencies at higher levels of QPE are important as potential clinical applications of higher levels of BPE continue to grow. To date, higher levels of BPE have been associated with higher estrogenic states, [26][27][28][29][30][31] higher amounts of visceral adipose tissue, 32 a history of chest radiation for childhood lymphoma, 33 increased metabolic activity, 34 the presence of a breast cancer, 12 and the development of a breast cancer, 13 Higher pretreatment BPE in the contralateral breast has also been associated with a better response to neoadjuvant therapy in patients with unilateral breast cancer. 35,36 These findings underscore the potential utility of BPE as an imaging biomarker for stratifying breast cancer risk and assessing response to therapy.…”