title: Tumor metabolism and perfusion ratio assessed by 18F-FDG PET/CT and DCE-MRI in breast cancer patients: Correlation with tumor subtype and histologic prognostic factors.
abstract: OBJECTIVE
  Our purpose was to evaluate whether breast cancer with high metabolic-perfusion ratio would be associated with poor histopathologic prognostic factors and whether triple negative breast cancer (TNBC) would show high metabolic-perfusion ratio compared to non-triple negative breast cancer (non-TNBC).
  
  
  METHODS
  From March 2011 to November 2011, 67 females with invasive ductal carcinoma of breast who underwent both MRI and 18F-FDG PET/CT were included. Perfusion parameters including Ktrans, Kep and Ve were acquired from Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Metabolic parameters including the standardized uptake value (SUV) and volumetric metabolic parameters including metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were obtained from F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT).
  
  
  RESULTS
  In non-TNBC, SUVmax was significantly correlated with Kep (ρ=0.298, p=0.036) and Ve (ρ=-0.286, p=0.044). In TNBC, there was no significant correlation between all perfusion and metabolic parameters. Compared to non-TNBC, higher SUVmax (10.2 vs 5.3, p<0.001), higher SUVmax/Ktrans (56.02 vs 20.3, p<0.001), higher MTV50/Ktrans (7.8 vs 16.54, p<0.001), higher TLG50/Ktrans (36.49 vs 12.3, p<0.001), higher TLG50/Ve (91.34 vs 27.1 p=0.022) were significantly correlated with TNBC. Lower Ktrans (0.17 vs 0.29, p=0.017) and lower Ve (0.29 vs 0.41, p=0.011) were also significantly associated TNBC.
  
  
  CONCLUSIONS
  While several perfusion parameters and metabolic parameters were correlated in non-TNBC, they were not correlated in TNBC. TNBC showed higher metabolic-perfusion ratios compared to non-TNBC.
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, South Korea.
authors.forename: Young-Sil
authors.initials: YS
authors.lastname: An
authors.affiliation: Department of Radiology, Ajou University School of Medicine, South Korea.
authors.forename: Doo Kyoung
authors.initials: DK
authors.lastname: Kang
authors.affiliation: Department of Surgery, Ajou University School of Medicine, South Korea.
authors.forename: Yong Sik
authors.initials: YS
authors.lastname: Jung
authors.affiliation: Department of Surgery, Ajou University School of Medicine, South Korea.
authors.forename: Sehwan
authors.initials: S
authors.lastname: Han
authors.affiliation: Department of Radiology, Ajou University School of Medicine, South Korea. Electronic address: medhand@ajou.ac.kr.
authors.forename: Tae Hee
authors.initials: TH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000000981:diagnostic imaging / Q000473:pathology; D001943:Breast Neoplasms / Q000175:diagnosis / Q000378:metabolism*; D003287:Contrast Media; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Breast cancer; Dynamic contrast enhanced magnetic resonance imaging; Metabolism; PET CT; Perfusion; Triple negative breast cancer