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Prediction of biological characteristics of breast cancer using dual-phase FDG PET/CT

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to assess whether the retention index (RI) determined using dual-phase 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) reflects the malignant features of breast cancer.

Methods

A total of 1,523 patients with breast cancer were retrospectively evaluated. PET/CT scans were performed at 1 h and 2 h after FDG administration before treatment. The maximum standardized uptake value (SUVmax) at both time points (SUVmax1 and SUVmax2) in the primary tumour and RI were calculated. Primary tumour tissues were evaluated in terms of biological features, such as histology, nuclear grade, lymphovascular invasion and molecular subtype.

Results

Of the 1,523 patients, 463 (30.4%) had luminal A-like, 661 (43.4%) had luminal B-like, 229 (15.0%) had human epidermal growth factor receptor 2-positive (HER2-positive), and 157 (10.3%) triple-negative breast cancer. The median SUVmax1, SUVmax2 and RI values were 2.2, 2.3 and 2.6%, respectively. These metabolic parameters were correlated with tumour size, nodal metastasis, histology, nuclear grade, lymphovascular invasion, and molecular subtype (all P < 0.001). The median RI values were 0% in luminal A-like, 5.3% in luminal B-like, 6.9% in HER2-positive, and 11.4% in triple-negative breast cancer. RI was associated with malignant features when the tumour accumulated a significant amount of FDG. In a subanalysis of patients with tumours of stages T2 to T4, RI was correlated with nodal metastasis, histology, nuclear grade, and molecular subtype (luminal A-like 4.8%, luminal B-like 12.3%, HER2-positive 15.8%, and triple-negative 16.3%).

Conclusion

RI determined using delayed-phase FDG PET/CT is associated with malignant features in breast cancers with significant FDG uptake. Dual-phase imaging was helpful in distinguishing luminal A-like breast cancer from luminal B-like, HER2-positive, and triple-negative breast cancers.

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References

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin. 2017;67:7–30.

    Article  Google Scholar 

  2. Curigliano G, Burstein HJ, PW E, Gnant M, Dubsky P, Loibl S, et al. De-escalating and escalating treatments for early-stage breast cancer: the St. Gallen International Expert Consensus Conference on the Primary Therapy of Early Breast Cancer 2017. Ann Oncol. 2017;28:1700–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Goldhirsch A, Wood WC, Gelber RD, Coates AS, Thurlimann B, Senn HJ. Progress and promise: highlights of the international expert consensus on the primary therapy of early breast cancer 2007. Ann Oncol. 2007;18:1133–44.

    Article  CAS  PubMed  Google Scholar 

  4. Hong S, Li J, Wang S. 18FDG PET-CT for diagnosis of distant metastases in breast cancer patients. A meta-analysis. Surg Oncol. 2013;22:139–43.

    Article  PubMed  Google Scholar 

  5. Groheux D, Espie M, Giacchetti S, Hindie E. Performance of FDG PET/CT in the clinical management of breast cancer. Radiology. 2013;266:388–405.

    Article  PubMed  Google Scholar 

  6. Boerner AR, Weckesser M, Herzog H, Schmitz T, Audretsch W, Nitz U, et al. Optimal scan time for fluorine-18 fluorodeoxyglucose positron emission tomography in breast cancer. Eur J Nucl Med. 1999;26:226–30.

    Article  CAS  PubMed  Google Scholar 

  7. Lodge MA, Lucas JD, Marsden PK, Cronin BF, O’Doherty MJ, Smith MA. A PET study of 18FDG uptake in soft tissue masses. Eur J Nucl Med. 1999;26:22–30.

    Article  CAS  PubMed  Google Scholar 

  8. Hamberg LM, Hunter GJ, Alpert NM, Choi NC, Babich JW, Fischman AJ. The dose uptake ratio as an index of glucose metabolism: useful parameter or oversimplification? J Nucl Med. 1994;35:1308–12.

    CAS  PubMed  Google Scholar 

  9. Kumar R, Loving VA, Chauhan A, Zhuang H, Mitchell S, Alavi A. Potential of dual-time-point imaging to improve breast cancer diagnosis with (18)F-FDG PET. J Nucl Med. 2005;46:1819–24.

    PubMed  Google Scholar 

  10. Moon H, Noh WC, Kim HA, Kim EK, Park KW, Lee SS, et al. The relationship between estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 expression of breast cancer and the retention index in dual phase (18)F-FDG PET/CT. Nucl Med Mol Imaging. 2016;50:246–54.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. García Vicente AM, Castrejón ÁS, Relea Calatayud F, Muñoz AP, León Martín AA, López-Muñiz IC, et al. 18F-FDG retention index and biologic prognostic parameters in breast cancer. Clin Nucl Med. 2012;37:460–6.

    Article  PubMed  Google Scholar 

  12. García Vicente AM, Soriano Castrejón A, Relea Calatayud F, Muñoz Madero V, Molina Garrido MJ, León Martín AA, et al. 18F-FDG semi-quantitative parameters and biological prognostic factors in locally advanced breast cancer. Rev Esp Med Nucl Imagen Mol. 2012;31:308–14.

    PubMed  Google Scholar 

  13. García Vicente AM, Soriano Castrejón Á, León Martín A, Chacón López-Muñiz I, Muñoz Madero V, Muñoz Sánchez Mdel M, et al. Molecular subtypes of breast cancer: metabolic correlation with (1)(8)F-FDG PET/CT. Eur J Nucl Med Mol Imaging. 2013;40:1304–11.

    Article  CAS  PubMed  Google Scholar 

  14. Ozen A, Altinay S, Ekmekcioglu O, Albayrak R, Muhammedoglu A, Yigitbas H, et al. Dual-time (18)F-FDG PET/CT imaging in initial Locoregional staging of breast carcinoma: comparison with conventional imaging and pathological prognostic factors. Indian J Surg. 2016;78:382–9.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene F, Trotti A. AJCC cancer staging manual. 7th ed. New York: Springer; 2010.

    Google Scholar 

  16. Japanese Society of Nuclear Medicine. FDG-PET, PET/CT clinical practice guideline. 2012 (in Japanese). http://jsnm.sakura.ne.jp/wp_jsnm/wp-content/themes/theme_jsnm/doc/fdgpet_guideline2012_120912.pdf. Accessed 7 Jan 2019.

  17. Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant. 2013;48:452–8.

    Article  CAS  PubMed  Google Scholar 

  18. Gatenby RA, Gillies RJ. Why do cancers have high aerobic glycolysis? Nat Rev Cancer. 2004;4:891–9.

    Article  CAS  Google Scholar 

  19. Kadoya T, Aogi K, Kiyoto S, Masumoto N, Sugawara Y, Okada M. Role of maximum standardized uptake value in fluorodeoxyglucose positron emission tomography/computed tomography predicts malignancy grade and prognosis of operable breast cancer: a multi-institute study. Breast Cancer Res Treat. 2013;141:269–75.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Ekmekcioglu O, Aliyev A, Yilmaz S, Arslan E, Kaya R, Kocael P, et al. Correlation of 18F-fluorodeoxyglucose uptake with histopathological prognostic factors in breast carcinoma. Nucl Med Commun. 2013;34:1055–67.

    Article  CAS  PubMed  Google Scholar 

  21. Groheux D, Giacchetti S, Moretti JL, Porcher R, Espie M, Lehmann-Che J, et al. Correlation of high 18F-FDG uptake to clinical, pathological and biological prognostic factors in breast cancer. Eur J Nucl Med Mol Imaging. 2011;38:426–35.

    Article  PubMed  Google Scholar 

  22. Ueda S, Tamaki Y, Yano K, Okishiro N, Yanagisawa T, Imasato M, et al. Cosmetic outcome and patient satisfaction after skin-sparing mastectomy for breast cancer with immediate reconstruction of the breast. Surgery. 2008;143:414–25.

    Article  PubMed  Google Scholar 

  23. Soret M, Bacharach SL, Buvat I. Partial-volume effect in PET tumor imaging. J Nucl Med. 2007;48:932–45.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors thank Kazushi Marukawa and Masatsugu Tsujimura of Chuden Hospital for providing data regarding PET examinations. The authors also thank Ai Shimamoto for data management.

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Authors and Affiliations

  1. Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima City, Hiroshima, 734-8551, Japan

    Shinsuke Sasada, Norio Masumoto, Eri Suzuki, Satoshi Sueoka, Noriko Goda, Keiko Kajitani, Akiko Emi, Takayuki Kadoya & Morihito Okada

Authors
  1. Shinsuke Sasada
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  2. Norio Masumoto
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  3. Eri Suzuki
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  4. Satoshi Sueoka
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  5. Noriko Goda
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  6. Keiko Kajitani
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  7. Akiko Emi
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  8. Takayuki Kadoya
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  9. Morihito Okada
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Correspondence to Shinsuke Sasada.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Sasada, S., Masumoto, N., Suzuki, E. et al. Prediction of biological characteristics of breast cancer using dual-phase FDG PET/CT. Eur J Nucl Med Mol Imaging 46, 831–837 (2019). https://doi.org/10.1007/s00259-019-4259-5

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  • DOI: https://doi.org/10.1007/s00259-019-4259-5

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