FDG-PET/MRI enhances breast cancer diagnosis and staging

By Wayne Forrest, AuntMinnie.com contributing writer

November 11, 2015 --

Tuesday, December 1 | 3:00 p.m.-3:10 p.m. | SSJ02-01 | Room E450A
Multiparameter FDG-PET/MRI can improve the specificity of dynamic contrast-enhanced MRI, which could lead to more-accurate staging of breast lesions and fewer false positives and unnecessary biopsies.

"Breast MRI has been shown to be very sensitive," wrote study presenter Dr. Courtney Garlick, with Radiology Muskegon in Muskegon, MI, in an email to AuntMinnie.com. "However, there is room for improvement of specificity, and this multiparametric approach combining breast MRI and PET imaging was able to demonstrate an improved specificity."

In the study, the researchers sought to assess the performance of multiparametric FDG-PET/MRI using dynamic contrast-enhanced MRI (DCE-MRI), diffusion-weighted imaging (DWI), and FDG-PET to differentiate between benign and malignant breast lesions.

Garlick and colleagues prospectively enrolled more than two dozen newly diagnosed breast cancer patients who underwent FDG-PET/MRI. DCE-MRI identified breast abnormalities, which were then evaluated for malignancy based on each method (DCE-MRI, DWI, and PET), alone and in combination.

Among the 60 lesions found, 43 were deemed malignant. Multiparameter PET/MRI significantly improved specificity compared with DCE-MRI, DCE-MRI combined with PET, or diffusion-weighted imaging, the researchers found.

"The potential clinical benefits include improved differentiation between benign and malignant lesions identified on breast MRI," Garlick said.

PET/MRI could also be useful for evaluating response to chemotherapy, and perhaps even for predicting response to chemotherapy based on the multiparametric imaging findings prior to treatment.

It is still early in the evaluation of FDG-PET/MRI, and only a small study group was used, Garlick noted.

She and her colleagues hope to expand their research to include more patients, and they are considering studying different PET agents that target different breast cancer genotypes to further increase specificity.