Multiparametric and Multimodality Functional Radiological Imaging for Breast Cancer Diagnosis and Early Treatment Response Assessment

Abstract

Breast cancer is the second leading cause of cancer death among US women, and the chance of a woman developing breast cancer sometime during her lifetime is one in eight. Early detection and diagnosis to allow appropriate locoregional and systemic treatment are key to improve the odds of surviving its diagnosis. Emerging data also suggest that different breast cancer subtypes (phenotypes) may respond differently to available adjuvant therapies. There is a growing understanding that not all patients benefit equally from systemic therapies, and therapeutic approaches are being increasingly personalized based on predictive biomarkers of clinical benefit. Optimal use of established and novel radiological imaging methods, such as magnetic resonance imaging and positron emission tomography, which have different biophysical mechanisms can simultaneously identify key functional parameters. These methods provide unique multiparametric radiological signatures of breast cancer, that will improve the accuracy of early diagnosis, help select appropriate therapies for early stage disease, and allow early assessment of therapeutic benefit.

Imaging Considerations and Interprofessional Opportunities in the Care of Breast Cancer Patients in the Neoadjuvant Setting

“…26 The integration of multiple imaging modalities results in the combination of different functional imaging metrics, allowing for enhanced characterization of tumor physiology and microenvironment, before and after treatment. 26,97 Beginning with the development of hybrid PET/CT and SPECT/CT scanners, early multimodality imaging technologies aimed to pair molecular imaging data with high-resolution anatomical data for improved lesion localization and detection. 26,97 Studies evaluating 18 F-FDG-PET prediction of breast cancer NAT response predominantly use PET/CT scanners to image radiotracer uptake, and demonstrate improved lesion detection over CT evaluation alone.…”

“…26,97 Beginning with the development of hybrid PET/CT and SPECT/CT scanners, early multimodality imaging technologies aimed to pair molecular imaging data with high-resolution anatomical data for improved lesion localization and detection. 26,97 Studies evaluating 18 F-FDG-PET prediction of breast cancer NAT response predominantly use PET/CT scanners to image radiotracer uptake, and demonstrate improved lesion detection over CT evaluation alone. 87,98 More recently, there has been interest in pairing PET with MRI, to determine if the additional anatomical and functional characterizations derived from MRI can improve prediction of NAT response in breast cancer patients.…”

Multiparametric deep learning tissue signatures for a radiological biomarker of breast cancer: Preliminary results

“…Moreover, the MRI parameters, as well as, the time resolution of the DCE image phases used to train the MPDL model were different for our dataset and the validation dataset reasserting the robust nature of the MPDL model and eliminates the need to "retrain" the MPDL model. The mpMRI parameters used in this study were based on our and others previous results in patients 1,3,4,30 . These studies demonstrated that the combined MRI sequences consisting of DWI, ADC, and PK-DCE were highly correlated with the histological phenotype of the tissue.…”

Vision 20/20: Simultaneous CT‐MRI — Next chapter of multimodality imaging

“…Combined imaging modalities frequently use contrast agents-radiopharmaceuticals, intravascular agents, and multifunctional nanoparticles to expand their capabilities. 27,28 Since conventional CT and MRI currently use different dedicated agents, [29][30][31][32] the potential for multifunctional CT-MRI nanoparticles is particularly important. 33…”