Metabolic-flow relationships in primary breast cancer: feasibility of combined PET/dynamic contrast-enhanced CT

To assess the feasibility and first experience of combined (18)F-FDG-PET)/dynamic contrast-enhanced (DCE) CT in evaluating breast cancer. Nine consecutive female patients (mean age 64.2 years, range 52-74 years) with primary breast carcinoma were prospectively recruited for combined (18)F-FDG PET/DCE-CT. Dynamic CT data were used to calculate a range of parameters of tumour vascularity, and tumour (18)F-FDG uptake (standardized uptake value, SUVmax) was used as a metabolic indicator. One tumour did not enhance and was excluded. The mean tumour SUVmax was 7.7 (range 2.4-26.1). The mean values for tumour perfusion, perfusion normalized to cardiac output, standard perfusion value (SPV) and permeability were 41 ml/min per 100 g (19-59 ml/min per 100 g), 0.56%/100 g (0.33-1.09%/100 g), 3.6 (2.5-5.9) and 0.15/min (0.09-0.30/min), respectively. Linear regression analysis showed a positive correlation between tumour SUV and tumour perfusion normalized to cardiac output (r=0.55, p=0.045) and a marginal correlation between tumour SUV and tumour SPV (r=0.19, p=0.065). There were no significant correlations between tumour SUV and tumour perfusion (r=0.29, p=0.401) or permeability (r=0.03, p=0.682). The first data from combined (18)F-FDG-PET/DCE-CT in breast cancer are reported. The technique was successful in eight of nine patients. Breast tumour metabolic and vascular parameters were consistent with previous data from (15)O-H(2)O-PET.