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MR/PET Determines Chemotherapy's Effectiveness in Breast Cancer Patients

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For patients with advanced breast cancer, positron emission tomography (PET) and magnetic resonance (MR) imaging can enhance the quality of life and increase chances of survival by supplying doctors with information on the efficiency of chemotherapy prior to surgery.mr pet breast cancer

The researchers who shared their findings at the annual meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI) held in Vancouver (BC, Canada), June 2013, combined individual imaging systems, PET, MR, and computed tomography (CT), to outline the course of chemotherapy before surgery, referred to as neoadjuvant chemotherapy.

All these diverse imaging units supply corresponding information, both structural and physiologic, on how chemotherapy will be disseminated throughout the body to eliminate breast cancer and metastatic tumors. Researchers utilized a dedicated molecular imaging agent called F-18 fluorodeoxyglucose (FDG) that operates as a biomarker for cellular metabolism with PET to mark areas of cancer metastasis.

“Previous studies have shown that, separately, FDG PET and dynamic enhanced MR imaging 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 current director of the department of nuclear medicine, and until 2006, director of the National Radiation Emergency Medical Center of the Korea Institute of Radiological and Medical Sciences (Seoul, Republic of Korea), Sang Moo Lim, MD.

“Using both FDG PET and MR imaging to predict cancer progression-free survival allows us to apply more aggressive therapies that could potentially halt patients’ cancers and extend their lives.”

The study, which calculated the overall survival rate following chemotherapy, enrolled 44 women known to have advanced breast cancer. All patients were subjected to three rounds of neoadjuvant chemotherapy and whole-body FDG PET/CT, breast MR, and delayed breast PET/CT totaling four times.

Once before the first round of chemotherapy, then again following the first round, then after the second round, and finally once more before undergoing surgery, to assess and verify disease-free survival.

Data results showed that patient survival with no resurgence of cancer after neoadjuvant chemotherapy was gauged to be a little under three months to around three years for an average rate of 661 days.

“Additionally, this study demonstrates the collective potential of these imaging systems, which provides evidence that fused PET/MR utilizing both metabolic and vascular perfusion imaging can benefit patients. 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,” said Lim.

The study exhibited great promise when merging PET and MR imaging, supplying added evidence of the pros of simultaneous PET/MR imaging.

“This extends beyond just breast cancer. 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,” concluded Lim.


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