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Romeo V, Helbich TH, Pinker K. Breast PET/MRI Hybrid Imaging and Targeted Tracers. J Magn Reson Imaging 2023; 57:370-386. [PMID: 36165348 PMCID: PMC10074861 DOI: 10.1002/jmri.28431] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 01/20/2023] Open
Abstract
The recent introduction of hybrid positron emission tomography/magnetic resonance imaging (PET/MRI) as a promising imaging modality for breast cancer assessment has prompted fervent research activity on its clinical applications. The current knowledge regarding the possible clinical applications of hybrid PET/MRI is constantly evolving, thanks to the development and clinical availability of hybrid scanners, the development of new PET tracers and the rise of artificial intelligence (AI) techniques. In this state-of-the-art review on the use of hybrid breast PET/MRI, the most promising advanced MRI techniques (diffusion-weighted imaging, dynamic contrast-enhanced MRI, magnetic resonance spectroscopy, and chemical exchange saturation transfer) are discussed. Current and experimental PET tracers (18 F-FDG, 18 F-NaF, choline, 18 F-FES, 18 F-FES, 89 Zr-trastuzumab, choline derivatives, 18 F-FLT, and 68 Ga-FAPI-46) are described in order to provide an overview on their molecular mechanisms of action and corresponding clinical applications. New perspectives represented by the use of radiomics and AI techniques are discussed. Furthermore, the current strengths and limitations of hybrid PET/MRI in the real world are highlighted. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Valeria Romeo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Thomas H Helbich
- Division of General and Pediatric Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Wien, Austria
| | - Katja Pinker
- Division of General and Pediatric Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Wien, Austria.,Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Wang J, Wang MY, Kuo WH, Chen KL, Shih TTF. Proton MR spectroscopy of normal breasts: Association of risk factors for breast cancer with water and lipid composition of the breast. Magn Reson Imaging 2016; 34:524-8. [DOI: 10.1016/j.mri.2015.12.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 12/15/2015] [Indexed: 10/22/2022]
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Shakweer MM, AwadAllah AA, Sayed MM, Mostafa AM. Role of sonoelastography and MR spectroscopy in diagnosis of solid breast lesions with histopathological correlation. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2015. [DOI: 10.1016/j.ejrnm.2015.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Kristian A, Riss P, Qu H, Milde M, Schoultz BW, Engebraaten O, Mælandsmo GM, Malinen E. Positron emission tomography and pharmacokinetics of 2-[18F]-fluoroethyl choline for metabolic studies in breast cancer xenografts. Acta Oncol 2014; 53:1086-92. [PMID: 25017377 DOI: 10.3109/0284186x.2014.934398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Breast carcinomas (BC) can have abnormal choline (Cho) metabolism. Earlier studies indicated that Cho uptake can differ between different subtypes of BC. The purpose of this study was to investigate uptake of 2-[(18)F]-fluoroethyl-choline ([(18)F]FECh) in three different patient-derived breast cancer xenografts (BCXs) using dynamic positron emission tomography (dPET). MATERIAL AND METHODS Nine athymic nude mice bearing bilateral MAS98.12 (basal-like), HBCx34 or MAS98.06 (both luminal B) BCXs were subjected to a 90-minute dPET scan following a bolus injection of 10 MBq of [(18)F]FECh. A Patlak Plot analysis and a well-established two-tissue compartment model were fitted to the uptake curves of the whole tumors, providing estimates of transfer rates between the vascular, non-metabolized and metabolized compartments. Patlak slope KP and intercept V, the rate constants k₁, k₂, k₃, the intravascular fraction vb and MR[(18)F]FECh were estimated. Additionally, analyses of terminal blood samples and tumor cell suspension incubated with [(18)F]FECh were performed. RESULTS [(18)F]FECh uptake in all BCXs was similar to surrounding normal tissue, thus creating no image contrast. The average liver uptake was 10 times higher than the tumor uptake. The uptake in MAS98.12 was higher than in the other two BCXs during the whole course of the acquisition, and was significantly higher than in HBCx34 at 10-30 minutes after injection. No significant differences were found for k1, MR[(18)F]FECh and intravascular fraction vb. Patlak slope KP, k₂ and k₃ were significantly lower for the MAS98.12 xenograft, in line with in vitro results. KP was correlated with both MR[(18)F]FECh and k₃. CONCLUSIONS dPET demonstrated that different subtypes of breast cancer have different uptake of [(18)F]FECh. Differences in rate constants and KP were in line with in vitro uptake in cell suspensions and earlier spectroscopy and gene expression analysis.
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Affiliation(s)
- Alexandr Kristian
- Department of Tumor Biology, Oslo University Hospital , Oslo , Norway
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The antitumor effect of formosanin C on HepG2 cell as revealed by 1H-NMR based metabolic profiling. Chem Biol Interact 2014; 220:193-9. [PMID: 25014414 DOI: 10.1016/j.cbi.2014.06.023] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 05/22/2014] [Accepted: 06/20/2014] [Indexed: 12/26/2022]
Abstract
Formosanin C (FC) is a pure compound isolated from Rhizoma Paridis. In the past years, antitumor effects of FC have been observed in several cultural cells and animal systems. However, there was no research particular on liver cancer. In this experiment, 3-(4, 5-dimethylthiazol diphenyltetrazolium bromide (MTT) dye reduction assay was used to evaluate cell viability of HepG2 cells with FC-treatment. 4', 6-diamidino-2-phenylindole (DAPI) staining, Annexin V-FITC/PI assay and DNA fragment assay were applied to observe FC-induced apoptosis. Cell cycle analysis and NMR metabolic profiles were used to identify molecular mechanisms of FC in HepG2 cells. As a result, FC inhibited the growth of HepG2 cells through inducing apoptosis and S phase arrest. Cells cultured in the presence or absence of FC was different in metabolic profiles. The treatment decreased acetate, ethanol, choline and betaine, and increased butyrate, fatty acids, leucine and valine in HepG2 cells. In conclusion, metabolomic analysis of the exometabolome of FC-treated HepG2 cells, together with traditional methods such as apoptosis test and cell cycle analysis provided a holistic method for elucidating mechanisms of potential anti-cancer drug, FC.
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Magometschnigg HF, Helbich T, Brader P, Abeyakoon O, Baltzer P, Füger B, Wengert G, Polanec S, Bickel H, Pinker K. Molecular imaging for the characterization of breast tumors. Expert Rev Anticancer Ther 2014; 14:711-22. [DOI: 10.1586/14737140.2014.885383] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Pinker K, Bogner W, Gruber S, Brader P, Trattnig S, Karanikas G, Helbich TH. Molecular Imaging in Breast Cancer - Potential Future Aspects. Breast Care (Basel) 2011; 6:110-119. [PMID: 21673821 PMCID: PMC3104901 DOI: 10.1159/000328275] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
SUMMARY: Molecular imaging aims to visualize and quantify biological, physiological, and pathological processes at cellular and molecular levels. Recently, molecular imaging has been introduced into breast cancer imaging. In this review, we will present a survey of the molecular imaging techniques that are either clinically available or are being introduced into clinical imaging. We will discuss nuclear imaging and multiparametric magnetic resonance imaging as well as the combined application of molecular imaging in the assessment of breast lesions. In addition, we will briefly discuss other evolving molecular imaging techniques, such as phosphorus magnetic resonance spectroscopic imaging and sodium imaging.
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Affiliation(s)
- Katja Pinker
- Universitätsklinik für Radiodiagnostik, Division für Molekulare und Gender Bildgebung, Austria
| | - Wolfgang Bogner
- Universitätsklinik für Radiodiagnostik, Division für Molekulare und Gender Bildgebung, Austria
- MR Exzellenzzentrum, Universitätsklinik für Radiodiagnostik, Austria
| | - Stephan Gruber
- Universitätsklinik für Radiodiagnostik, Division für Molekulare und Gender Bildgebung, Austria
- MR Exzellenzzentrum, Universitätsklinik für Radiodiagnostik, Austria
| | - Peter Brader
- Universitätsklinik für Radiodiagnostik, Division für Molekulare und Gender Bildgebung, Austria
| | - Siegfried Trattnig
- Universitätsklinik für Radiodiagnostik, Division für Molekulare und Gender Bildgebung, Austria
- MR Exzellenzzentrum, Universitätsklinik für Radiodiagnostik, Austria
| | - Georgios Karanikas
- Universitätsklinik für Nuklearmedizin, Medizinische Universität Wien, Austria
| | - Thomas H. Helbich
- Universitätsklinik für Radiodiagnostik, Division für Molekulare und Gender Bildgebung, Austria
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Muralidhar GS, Bovik AC, Sampat MP, Whitman GJ, Haygood TM, Stephens TW, Markey MK. Computer-Aided Diagnosis in Breast Magnetic Resonance Imaging. ACTA ACUST UNITED AC 2011; 78:280-90. [DOI: 10.1002/msj.20248] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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O'Flynn EAM, DeSouza NM. Functional magnetic resonance: biomarkers of response in breast cancer. Breast Cancer Res 2011; 13:204. [PMID: 21392409 PMCID: PMC3109577 DOI: 10.1186/bcr2815] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Functional magnetic resonance (MR) encompasses a spectrum of techniques that depict physiological and molecular processes before morphological changes are visible on conventional imaging. As understanding of the pathophysiological and biomolecular processes involved in breast malignancies evolves, newer functional MR techniques can be employed that define early predictive and surrogate biomarkers for monitoring response to chemotherapy. Neoadjuvant chemotherapy is increasingly used in women with primary breast malignancies to down-stage the tumour and enable successful breast conservation surgery. It also plays a role in the treatment of undetected micrometastases. Cardinal physiological features of tumours that occur as a result of interactions between cancer cells, stromal cells and secreted factors and cytokines and how they change with treatment provide the opportunity to detect changes in the tumour microenvironment prior to any morphological change. Through sequential imaging, tumour response can be assessed and non-responders can be identified early to enable alternative therapies to be considered. This review summarises the functional magnetic resonance biomarkers of response in patients with breast cancer that are currently available and under development. We describe the current state of each biomarker and explore their potential clinical uses and limitations in assessing treatment response. With the aid of selected interesting cases, biomarkers related to dynamic contrast-enhanced MRI, diffusion-weighted MRI, T2*/BOLD and MR spectroscopy are described and illustrated. The potential of newer approaches, such as MR elastography, are also reviewed.
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Affiliation(s)
- Elizabeth A M O'Flynn
- Clinical Magnetic Resonance Group, Institute of Cancer Research, Royal Marsden NHS Foundation Trust, Sutton, Surrey, SM2 5PT, UK.
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Tozaki M, Maruyama K. Current Status and Future Prospects of Proton MR Spectroscopy of the Breast with a 1.5T MR Unit. JOURNAL OF ONCOLOGY 2010; 2010:781621. [PMID: 20953323 PMCID: PMC2952948 DOI: 10.1155/2010/781621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2010] [Accepted: 09/01/2010] [Indexed: 11/17/2022]
Abstract
Proton MR spectroscopy of the mammary gland area is used to be considered in the realm of basic research, but as a result of the advances in MR techniques, it is now being performed in ordinary clinical practice. It is particularly noteworthy that useful clinical data are now being accumulated with 1.5T MR units, which are the standard units. We think that, at this point, it is very important to systematically review the techniques, clinical applications, and future prospects of proton MR spectroscopy. We have performed proton MR spectroscopy with a 1.5T MR unit in over 3000 cases at our hospital. In this paper, we will comment on the current status of proton MR spectroscopy of the breast, primarily in regard to differentiation between benign and malignant lesions and prediction of the efficacy of chemotherapy while describing the data obtained at our hospital.
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Affiliation(s)
- Mitsuhiro Tozaki
- Breast Center, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan
| | - Katsuya Maruyama
- Siemens Japan K.K. Healthcare Sector, 3-20-14 Higashi-Gotanda, Shinagawa-ku, Tokyo 141-8644, Japan
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Moestue SA, Borgan E, Huuse EM, Lindholm EM, Sitter B, Børresen-Dale AL, Engebraaten O, Maelandsmo GM, Gribbestad IS. Distinct choline metabolic profiles are associated with differences in gene expression for basal-like and luminal-like breast cancer xenograft models. BMC Cancer 2010; 10:433. [PMID: 20716336 PMCID: PMC2931488 DOI: 10.1186/1471-2407-10-433] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Accepted: 08/17/2010] [Indexed: 01/05/2023] Open
Abstract
Background Increased concentrations of choline-containing compounds are frequently observed in breast carcinomas, and may serve as biomarkers for both diagnostic and treatment monitoring purposes. However, underlying mechanisms for the abnormal choline metabolism are poorly understood. Methods The concentrations of choline-derived metabolites were determined in xenografted primary human breast carcinomas, representing basal-like and luminal-like subtypes. Quantification of metabolites in fresh frozen tissue was performed using high-resolution magic angle spinning magnetic resonance spectroscopy (HR MAS MRS). The expression of genes involved in phosphatidylcholine (PtdCho) metabolism was retrieved from whole genome expression microarray analyses. The metabolite profiles from xenografts were compared with profiles from human breast cancer, sampled from patients with estrogen/progesterone receptor positive (ER+/PgR+) or triple negative (ER-/PgR-/HER2-) breast cancer. Results In basal-like xenografts, glycerophosphocholine (GPC) concentrations were higher than phosphocholine (PCho) concentrations, whereas this pattern was reversed in luminal-like xenografts. These differences may be explained by lower choline kinase (CHKA, CHKB) expression as well as higher PtdCho degradation mediated by higher expression of phospholipase A2 group 4A (PLA2G4A) and phospholipase B1 (PLB1) in the basal-like model. The glycine concentration was higher in the basal-like model. Although glycine could be derived from energy metabolism pathways, the gene expression data suggested a metabolic shift from PtdCho synthesis to glycine formation in basal-like xenografts. In agreement with results from the xenograft models, tissue samples from triple negative breast carcinomas had higher GPC/PCho ratio than samples from ER+/PgR+ carcinomas, suggesting that the choline metabolism in the experimental models is representative for luminal-like and basal-like human breast cancer. Conclusions The differences in choline metabolite concentrations corresponded well with differences in gene expression, demonstrating distinct metabolic profiles in the xenograft models representing basal-like and luminal-like breast cancer. The same characteristics of choline metabolite profiles were also observed in patient material from ER+/PgR+ and triple-negative breast cancer, suggesting that the xenografts are relevant model systems for studies of choline metabolism in luminal-like and basal-like breast cancer.
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Affiliation(s)
- Siver A Moestue
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
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Pinker K, Stadlbauer A, Bogner W, Gruber S, Helbich TH. Molecular imaging of cancer: MR spectroscopy and beyond. Eur J Radiol 2010; 81:566-77. [PMID: 20554145 DOI: 10.1016/j.ejrad.2010.04.028] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 04/25/2010] [Accepted: 04/27/2010] [Indexed: 11/18/2022]
Abstract
Proton magnetic resonance spectroscopic imaging is a non-invasive diagnostic tool for the investigation of cancer metabolism. As an adjunct to morphologic and dynamic magnetic resonance imaging, it is routinely used for the staging, assessment of treatment response, and therapy monitoring in brain, breast, and prostate cancer. Recently, its application was extended to other cancerous diseases, such as malignant soft-tissue tumours, gastrointestinal and gynecological cancers, as well as nodal metastasis. In this review, we discuss the current and evolving clinical applications of proton magnetic resonance spectroscopic imaging. In addition, we will briefly discuss other evolving techniques, such as phosphorus magnetic resonance spectroscopic imaging, sodium imaging and diffusion-weighted imaging in cancer assessment.
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Affiliation(s)
- K Pinker
- Department of Radiology, Division of Molecular and Gender Imaging, Medical University Vienna, Austria
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