title: Simultaneous PET/MRI assessment of response to cytotoxic and hormone neo-adjuvant chemotherapy in breast cancer: a preliminary report.
abstract: The aim of this study was to assess the response to cytotoxic and hormone neo-adjuvant chemotherapy in four patients with locally advanced breast cancer by simultaneous PET/MRI. Four patients with locally advanced breast cancer underwent simultaneous PET/MRI of the breast using a 3 T Biograph mMR before and after neo-adjuvant chemotherapy (two patients were treated with hormone-therapy and two patients were treated with cytotoxic chemotherapy). Morpho-structural tumoral features and tumor size were assessed; area value, metabolic (SUV and MTV) and functional (ADC, Ktrans, Ve, kepand iAUC) data were obtained by positioning regions of interest. A comparison of all parameters between the pre- and post-treatment PET/MRI examinations and between the two different therapeutic schedules was assessed. In patients treated with cytotoxic chemotherapy and classified as PR, there was a significant reduction of post-treatment morphological, metabolic and functional parameters. In a patient treated with hormone therapy, classified as SD, there was an increase of all post-treatment perfusion parameters, a substantially stable ADC value and a poor reduction of lesion size and of maximum SUV (SUVmax) values; the last patient, treated with hormone therapy and classified as PR, showed a significant reduction of lesion size and SUVmaxvalues with a reduction of perfusion parameters and substantially stable ADC values. Multiparametric evaluation with simultaneous PET/MRI could be a useful tool to assess the response to cytotoxic and hormone neo-adjuvant chemotherapy in patients with breast cancer. Future studies in a larger cohort of patients are warranted to confirm the results of this preliminary study.
authors.affiliation: Department of Advanced Biomedical Sciences, University Federico II of Naples, Via S. Pansini, 5, 80123, Naples, Italy. valeria.romeo@unina.it.
authors.forename: Valeria
authors.identifier: http://orcid.org/0000-0002-1603-6396
authors.initials: V
authors.lastname: Romeo
authors.affiliation: Breast Department, National Cancer Institute of Naples IRCCS "G. Pascale", Naples, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: D'Aiuto
authors.affiliation: Breast Department, National Cancer Institute of Naples IRCCS "G. Pascale", Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Frasci
authors.affiliation: Department of Advanced Biomedical Sciences, University Federico II of Naples, Via S. Pansini, 5, 80123, Naples, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Imbriaco
authors.affiliation: IRCCS SDN, Naples, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Nicolai
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D020360:Neoadjuvant Therapy; D049268:Positron-Emission Tomography / Q000379:methods
chemical_list: D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal
keywords: Breast cancer; Neo-adjuvant chemotherapy; Simultaneous PET/MRI