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Review
. 2022 Jan;23(1):e32-e43.
doi: 10.1016/S1470-2045(21)00577-5.

Clinical advances in PET-MRI for breast cancer

Amy M Fowler  1 , Roberta M Strigel  2
Affiliations
Review

Clinical advances in PET-MRI for breast cancer

Amy M Fowler et al. Lancet Oncol. 2022 Jan.

Abstract

Imaging is paramount for the early detection and clinical staging of breast cancer, as well as to inform management decisions and direct therapy. PET-MRI is a quantitative hybrid imaging technology that combines metabolic and functional PET data with anatomical detail and functional perfusion information from MRI. The clinical applicability of PET-MRI for breast cancer is an active area of research. In this Review, we discuss the rationale and summarise the clinical evidence for the use of PET-MRI in the diagnosis, staging, prognosis, tumour phenotyping, and assessment of treatment response in breast cancer. The continued development and approval of targeted radiopharmaceuticals, together with radiomics and automated analysis tools, will further expand the opportunity for PET-MRI to provide added value for breast cancer imaging and patient care.

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Conflict of interest statement

Declaration of interests RMS reports research support from GE Healthcare paid to her institution. AMF reports book chapter royalties from Elsevier, lecture honorarium from the Wisconsin Association of Hematology and Oncology, research support from GE Healthcare paid to her institution, and grant funding from The Mary Kay Foundation and the Education and Research Foundation for Nuclear Medicine and Molecular Imaging.

Figures

Figure 1:
Figure 1:
Simultaneous PET/MRI protocol. For dedicated prone breast PET/MRI, PET data is acquired at one bed-position during the MRI sequences [attenuation correction (MRAC);fluid-sensitive/T2;diffusion-weighted imaging (DWI);dynamic contrast-enhanced (DCE) T1]. For supine whole-body PET/MRI, MRI sequences are acquired with PET data at each bed-position.
Figure 2:
Figure 2:
Dedicated prone breast FDG PET/MRI demonstrating cT2cN1 clinical anatomic staging (mammography/ultrasound/palpation=cT2cN0). Right breast invasive ductal carcinoma (SUVmax=15.1;A). Right level I axillary lymph node (SUVmax=3.0;B). Pathologic stage=pT2pN1a.
Figure 3:
Figure 3:
Dedicated prone breast FDG PET/MRI demonstrating cT3cN3b clinical anatomic staging (mammography/ultrasound/palpation=cT2cN1). Left internal mammary lymph node (SUVmax=6.9;A), level I axillary lymph node (SUVmax=14.4;B), left breast invasive ductal carcinoma (SUVmax=12.2;C). Pathologic stage=ypT3ypN2a.
See this image and copyright information in PMC

References

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