The aim of this study was to evaluate the value of MRI spectroscopy and its association with the altered glucose metabolism on FDG-18 PET/CT in patients with suspicious breast cancer evaluated by the BIRADS scoring system.
Methods and Materials
In the prospective group , eight breast cancer patients with BIRADS 4 or 5 on mammogram criteria were recruited from an endocrinology clinic. All patients underwent 18F-FDG PET/CT and MRI (spectroscopy) from September 2015- January 2016. For the purpose of interpretation, results were analyzed according to the qualitative assessment on a per lesion basis on the FDG-PET/CT. A positive PET was determined when there was higher inherent metabolic activity than the mediastinal blood pool. The standardized uptake value (SUVmax) was analysed to determine the degree of altered glucose metabolism on PET. In vivo proton, MR spectroscopy(MRS) of the breast was performed by measuring the metabolite ratios of the tumor lesions.
There were 8 females with a mean age of 55.3±12.2 years with biopsy result of invasive ductal carcinoma (2), lobular carcinoma (1), fibro adenomatous (3), pseudo-angiomatous stromal hyperplasia (1) and fibroadenomas (1). There was a significant difference between malignant (SUVmax mean 4.28±3.74 g/ml) versus benign (SUVmax mean;2.33±0.9 g/ml) .On personal basis of MRS , the suspicious breast tissue exhibited raised creatinine metabolites (mean: 3.35± 0.54u) as compared to N-acetyl Aspartate (NAA), (mean; 2.83± 0.98 u); and choline (mean: 2.46± 0.70 u) ; p <0.05.
This study SHOWED that high SUVmax is associated with malignant cancer and the high creatinine metabolite could potentially be utilized as a surrogate marker for suspicious lesions on BIRADS mammogram scoring system.
Keywords: Breast cancer /choline / Positron emission tomography/Computed tomography / fluorodeoxyglucose / MRI spectroscopy (MR spect)