Metabolic and vascular features of dynamic contrast-enhanced breast magnetic resonance imaging and (15)O-water positron emission tomography blood flow in breast cancer

Acad Radiol. 2008 Oct;15(10):1246-54. doi: 10.1016/j.acra.2008.03.019.


Rationale and objectives: We sought to (1) describe associations between measures of tumor perfusion by dynamic contrast-enhanced breast magnetic resonance imaging (DCE-MRI), blood flow by (15)O-water positron emission tomography (PET) and metabolism by (18)F-fluorodeoxyglucose ((18)F)-FDG PET and (2) improve our understanding of tumor enhancement on MRI through independent measures of tumor metabolism and blood flow.

Materials and methods: We performed a retrospective analysis of the existing PET and MRI databases from the Departments of Nuclear Medicine and Radiology. We identified patients with locally advanced breast cancer who underwent (15)O-water/(18)F-FDG PET within 1 month of clinical DCE-MRI between February 2004 and August 2006. The (15)O-water PET blood flow and (18)F-FDG metabolic rate and tissue transport constant (K(1)) in the primary malignancy were calculated. DCE-MRI peak percent enhancement and peak signal enhancement ratio (SER) were measured for each tumor. Correlations and regression analysis of these variables were performed.

Results: Fifteen patients with complete PET and DCE-MRI data were included in the analysis cohort. Peak SER correlated significantly with blood flow (r = 0.73, P = .002) and K(1) (r = 0.76, P = .001). However, peak SER did not correlate significantly with FDG metabolic rate (r = 0.44, P = .101). There were no significant correlations between peak percent enhancement and any of the PET parameters.

Conclusions: Our findings suggest that tumor perfusion, represented by (15)O-water PET blood flow, is an important factor in the MRI enhancement of locally advanced breast cancer. A lack of correlation of FDG metabolic rate with blood flow and DCE-MRI kinetics suggests that (18)F-FDG PET provides complementary metabolic information independent of vascular factors.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Flow Velocity
  • Breast Neoplasms / blood supply
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / metabolism*
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Neovascularization, Pathologic / diagnostic imaging*
  • Neovascularization, Pathologic / metabolism*
  • Oxygen Radioisotopes / pharmacokinetics*
  • Positron-Emission Tomography / methods*
  • Radiopharmaceuticals / pharmacokinetics
  • Water / metabolism


  • Oxygen Radioisotopes
  • Radiopharmaceuticals
  • Water