Sequential PET/MRI Predicts Chemotherapy’s Ability to Improve Survival in Patients with Advanced Breast Cancer
For patients with advanced breast cancer, positron-emission tomography (PET) and magnetic resonance imaging (MRI) can improve quality of life and survival by providing physicians with information on the effectiveness of chemotherapy prior to surgery, according to researchers presenting at the 2013 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging.
Parallel PET/MRI
Researchers combined separate imaging systems—PET, MRI, and computed tomography (CT)—to map the course of neoadjuvant chemotherapy. In this study, scientists used F-18 fluorodeoxyglucose (FDG) to act as a biomarker for cellular metabolism with PET in order to pick up on areas of cancer proliferation.
“Previous studies have shown that, separately, FDG-PET and dynamic enhanced [MRI] can provide a prediction of how patients will respond to neoadjuvant treatment, but we have improved upon this concept by combining the two techniques side by side,” said Sang Moo Lim, MD, Director of the Department of Nuclear Medicine of the National Radiation Emergency Medical Center of the Korea Institute of Radiological and Medical Sciences in Seoul, Korea. “Using both FDG-PET and [MRI] to predict cancer progression-free survival allows us to apply more aggressive therapies that could potentially halt patients’ cancers and extend their lives.”
Study Details
This study evaluating survival after chemotherapy included a patient population of 44 women with advanced breast cancer. All underwent three cycles of neoadjuvant chemotherapy and sequential whole-body FDG-PET/CT, breast MRI, and delayed breast PET/CT a total of four times—once prior to the first course of chemotherapy, again after the first course, following the second course, and one more time prior to surgery to predict and confirm disease-free survival. Results of the study indicated that patient survival with no recurrence of cancer after neoadjuvant chemotherapy was anywhere from just under 3 months to about 3 years for a median of 661 days.
“Additionally, this study demonstrates the collective potential of these imaging systems, which provides evidence that fused PET/MRI utilizing both metabolic and vascular perfusion imaging can benefit patients,” said Dr. Lim. “Together these techniques can help clinicians classify patients and provide risk stratification to not only predict cancer recurrence after treatment but also avoid chemotherapy for those who probably would benefit more from an alternative treatment.”
Next Steps
This research using combined, sequential PET and MRI provides additional proof of the potential benefit of simultaneous PET/MRI, an emerging molecular imaging technology.
“This extends beyond just breast cancer,” Dr. Lim added. “We could potentially apply these technologies to other malignancies and develop some brilliant methods to improve clinical outcomes. Considering the results of our research, we now need to further develop the technology—not just imaging systems, but tracers and biomarkers—to advance our field. Research and development in nuclear medicine and molecular imaging can satisfy these demands for the future.”
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
