The value of 18f-fluorodeoxyglucose and MRI DWI in underpinning cellular reprogramming in breast cancer

Background: The value of Apparent diffusion coefficient (ADC) derived from the MRI-DWI in differentiating benign from malignant breast cancer is scarce. The known FDG-avid breast cancer is well known and the potential of correlating the ADC and the degree of altered glucose metabolism evaluated by SUV max (FDG PET) is largely unknown. Objective: The aim of this study is to determine correlations between SUV max (18 F-FDG PET/CT) and ADC value (MRI DWI) in patients with primary breast carcinoma. Subjects and Methods: There were 13 consecutive breast cancer patients with BIRADS 4 or 5 were recruited from an endocrinology clinic. All patients underwent 18F-FDG PET/CT and MRI DWI. For the purpose of interpretation, results were analyzed according to the standardized uptake value (SUV max) whereby a lesion with is higher inherent metabolic activity than the mediastinal blood pool on FDG-PET/CT determined a positive finding Multiparametric MRI of the breast utilizing MRI DWI was performed on all patients with b values, 50 and 900 s/mm2. Apparent Diffusion Coefficient (ADC) values were generated automatically through soft-ware system. Data were analyzed using the Kendell Tau correlation, ANOVA and independent t test. All statistical tests with P values <0.05 were considered statistically significant. Results: There were 13 female with mean age of 57±9.7 years with proven biopsy of malignant lesion (5;38.5%) and benign (8;61.5%). There was a significant different between mean SUVmax of primary malignant (5.36±2.24 g/dl) and benign was (1.85±0.33g/dl) ; p<0.05). On the lesion MRI-DWI, there was significant association between the high signal change of benign lesion versus malignancy with p<0.05. There was also significant difference between the ADCmin for malignant is (0.84±0.25×10−3 mm2/s) versus benign (1.53±0.19 mm), p < 0.05. A significant inverse Kendall tau’ correlation coefficient was found between SUV max and ADC min (r ;-0.46, p=0.03). Conclusion and future works: The utility of SUV max and ADC value in differentiating benign from malignant breast lesions are potentially powerful as a surrogate markers for early detection and therapeutic response for early recognition of high risk patient in developing breast cancer.