The combination of PET and MR imaging data can provide physicians with information on the effectiveness of chemotherapy prior to surgery, according to research presented at the annual meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI) in Vancouver.
Sang Moo Lim, MD, director of the department of nuclear medicine, National Radiation Emergency Medical Center of the Korea Institute of Radiological and Medical Sciences in Seoul, and colleagues leveraged PET, MR and CT to map the course of neoadjuvant chemotherapy.
“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,” Lim said in a release. “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.”
Lim and colleagues studied 44 women with advanced breast cancer who underwent three cycles of neoadjuvant chemotherapy. The imaging protocol consisted of sequential whole-body PET/CT, breast MR and delayed breast PET/CT, prior to the first course of chemotherapy, after the first course, following the second course and prior to surgery to predict and confirm disease-free survival.
Patient survival with no recurrence of cancer after neoadjuvant chemotherapy ranged from less than three months to approximately three years.
“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,” said 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.”
This research using combined, sequential PET and MR imaging provides additional proof of the potential benefit of simultaneous PET/MR imaging.
“This extends beyond just breast cancer,” 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.”