Romeo Valeria, D'Aiuto Massimiliano, Frasci Giuseppe, Imbriaco Massimo, Nicolai Emanuele
Department of Advanced Biomedical Sciences, University Federico II of Naples, Via S. Pansini, 5, 80123, Naples, Italy.
Breast Department, National Cancer Institute of Naples IRCCS "G. Pascale", Naples, Italy.
Med Oncol. 2017 Feb;34(2):18. doi: 10.1007/s12032-016-0876-z. Epub 2016 Dec 30.
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, K , V , k and 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 (SUV) values; the last patient, treated with hormone therapy and classified as PR, showed a significant reduction of lesion size and SUV values 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.
本研究的目的是通过同时进行正电子发射断层显像/磁共振成像（PET/MRI）来评估4例局部晚期乳腺癌患者对细胞毒性和激素新辅助化疗的反应。4例局部晚期乳腺癌患者在新辅助化疗前后使用3T Biograph mMR对乳房进行了同步PET/MRI检查（2例患者接受激素治疗，2例患者接受细胞毒性化疗）。评估了肿瘤的形态结构特征和肿瘤大小；通过设定感兴趣区域获得面积值、代谢数据（标准化摄取值和代谢肿瘤体积）和功能数据（表观扩散系数、速率常数、容积转移常数、速率常数和初始曲线下面积）。对治疗前和治疗后的PET/MRI检查之间以及两种不同治疗方案之间的所有参数进行了比较。在接受细胞毒性化疗且分类为部分缓解（PR）的患者中，治疗后的形态、代谢和功能参数显著降低。在接受激素治疗且分类为疾病稳定（SD）的1例患者中，所有治疗后的灌注参数增加，表观扩散系数值基本稳定，病变大小和最大标准化摄取值（SUV）降低不明显；最后1例接受激素治疗且分类为PR的患者，病变大小和SUV值显著降低，灌注参数降低，表观扩散系数值基本稳定。同步PET/MRI的多参数评估可能是评估乳腺癌患者对细胞毒性和激素新辅助化疗反应的有用工具。有必要在更大的患者队列中进行进一步研究以证实本初步研究的结果。
