title: PET/MR in invasive ductal breast cancer: correlation between imaging markers and histological phenotype.
abstract: BACKGROUND
  Differences in genetics and receptor expression (phenotypes) of invasive ductal breast cancer (IDC) impact on prognosis and treatment response. Immunohistochemistry (IHC), the most used technique for IDC phenotyping, has some limitations including its invasiveness. We explored the possibility of contrast-enhanced positron emission tomography magnetic resonance (CE-FDG PET/MR) to discriminate IDC phenotypes.
  
  
  METHODS
  21 IDC patients with IHC assessment of oestrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor-2 (HER2), and antigen Ki-67 (Ki67) underwent CE-FDG PET/MR. Magnetic resonance-perfusion biomarkers, apparent diffusion coefficient (ADC), and standard uptake value (SUV) were compared with IHC markers and phenotypes, using a Student's t-test and one-way ANOVA.
  
  
  RESULTS
  ER/PR- tumours demonstrated higher Kepmeanand SUVmaxthan ER or PR+ tumours. HER2- tumours displayed higher ADCmean, Kepmean, and SUVmaxthan HER2+tumours. Only ADCmeandiscriminated Ki67⩽14% tumours (lower ADCmean) from Ki67>14% tumours. PET/MR biomarkers correlated with IHC phenotype in 13 out of 21 patients (62%; P=0.001).
  
  
  CONCLUSIONS
  Positron emission tomography magnetic resonance might non-invasively help discriminate IDC phenotypes, helping to optimise individual therapy options.
authors.affiliation: Martinos Center for Biomedical Imaging, Harvard Medical School, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA.|Abdominal Imaging, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
authors.forename: Onofrio Antonio
authors.initials: OA
authors.lastname: Catalano
authors.affiliation: Department of Radiology, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA.
authors.forename: Gary Lloyd
authors.initials: GL
authors.lastname: Horn
authors.affiliation: Nuclear Medicine Unit, University of Rome 'La Sapienza', Viale del Policlinico 5, Rome 00161, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Signore
authors.affiliation: Breast Unit, Ospedale Moscati, Avellino 83010, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Iannace
authors.affiliation: Department of Pathology, Ospedale Moscati, Avellino 83010, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Lepore
authors.affiliation: Department of Biostatistics, Martinos Center for Biomedical Imaging, Harvard Medical School, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Vangel
authors.affiliation: Department of Radiology, Gamma Cord, Benevento 82100, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Luongo
authors.affiliation: Department of Radiology, University of Naples 'Federico II', Napoli 80131, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Catalano
authors.affiliation: Breast Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
authors.forename: Constance
authors.initials: C
authors.lastname: Lehman
authors.affiliation: Diagnostic Imaging, SDN, Via Gianturco 113, Napoli 80131, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Salvatore
authors.affiliation: Diagnostic Imaging, University of Naples 'Parthenope', Napoli 80131, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Soricelli
authors.affiliation: Department of Radiology, Martinos Center for Biomedical Imaging, Harvard Medical School, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA.
authors.forename: Ciprian
authors.initials: C
authors.lastname: Catana
authors.affiliation: Precision Medicine and Radiology, Harvard Medical School, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA.
authors.forename: Umar
authors.initials: U
authors.lastname: Mahmood
authors.affiliation: Department of Radiology, Martinos Center for Biomedical Imaging, Harvard Medical School, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA.
authors.forename: Bruce Robert
authors.initials: BR
authors.lastname: Rosen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D005500:Follow-Up Studies; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009367:Neoplasm Staging; D010641:Phenotype; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000378:metabolism; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D019788:Fluorodeoxyglucose F18; D019394:Ki-67 Antigen; D019275:Radiopharmaceuticals; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone