Abstract
ObjectiveHuman cancers display intra-tumor phenotypic heterogeneity and recent research has focused on developing image processing methods extracting imaging descriptors to characterize this heterogeneity. This work assesses the role of pretreatment 18F-FDG PET and DWI-MR with respect to the prognosis and prediction of neoadjuvant chemotherapy (NAC) outcomes when image features are used to characterize primitive lesions from breast cancer (BC).Materials and methodsA retrospective protocol included 38 adult women with biopsy-proven BC. Patients underwent a pre-therapy 18F-FDG PET/CT whole-body study and a pre-therapy breast multi-parametric MR study. Patients were then referred for NAC treatment and then for surgical resection, with an evaluation of the therapy response. Segmentation methods were developed in order to identify functional volumes both on 18F-FDG PET images and ADC maps. Macroscopic and histogram features were extracted from the defined functional volumes.ResultsOur work demonstrates that macroscopic and histogram features from 18F-FDG PET are able to biologically characterize primitive BC, and define the prognosis. In addition, histogram features from ADC maps are able to predict the response to NAC.ConclusionOur work suggests that pre-treatment 18F-FDG PET and pre-treatment DWI-MR provide useful complementary information for biological characterization and NAC response prediction in BC.
Highlights
Evidence has shown that human cancers frequently display intra-tumor phenotypic heterogeneity [1, 2], whose nature can have profound implications both on tumor development and therapeutic outcomes
Our work suggests that pre-treatment 18F-FDG positron emission tomography (PET) and pre-treatment diffusion-weighted imaging (DWI)-magnetic resonance (MR) provide useful complementary information for biological characterization and neoadjuvant chemotherapy (NAC) response prediction in breast cancer (BC)
Our work evaluates the role of 18F-FDG PET/computerized tomography (CT) and DWI-MR in BC when both macroscopic and imaging features are extracted for prognosis of BC and prediction of the response to NAC
Summary
Evidence has shown that human cancers frequently display intra-tumor phenotypic heterogeneity [1, 2], whose nature can have profound implications both on tumor development and therapeutic outcomes. Measuring such heterogeneity could, be extremely useful in selecting the most promising therapeutic approach for an individual patient. The translation of ex vivo omics technologies is an open issue due to the low availability of such platforms within hospitals, the high costs, limited accuracy and long time schedules required. Most of the procedures are invasive and often require tissue sample extraction
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