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Correlation of breast cancer subtypes, based on estrogen receptor, progesterone receptor, and HER2, with functional imaging parameters from 68Ga-RGD PET/CT and 18F-FDG PET/CT

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Abstract

Purpose

Imaging biomarkers from functional imaging modalities were assessed as potential surrogate markers of disease status. Specifically, in this prospective study, we investigated the relationships between functional imaging parameters and histological prognostic factors and breast cancer subtypes.

Methods

In total, 43 patients with large or locally advanced invasive ductal carcinoma (IDC) were analyzed (47.6 ± 7.5 years old). 68Ga-Labeled arginine-glycine-aspartic acid (RGD) and 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) were performed. The maximum and average standardized uptake values (SUVmax and SUVavg) from RGD PET/CT and SUVmax and SUVavg from FDG PET/CT were the imaging parameters used. For histological prognostic factors, estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression was identified using immunohistochemistry (IHC) or fluorescent in situ hybridization (FISH). Four breast cancer subtypes, based on ER/PR and HER2 expression (ER/PR+,Her2−, ER/PR+,Her2+, ER/PR−,Her2+, and ER/PR−,Her2−), were considered.

Results

Quantitative FDG PET parameters were significantly higher in the ER-negative group (15.88 ± 8.73 vs 10.48 ± 6.01, p = 0.02 for SUVmax; 9.40 ± 5.19 vs 5.92 ± 4.09, p = 0.02 for SUVavg) and the PR-negative group (8.37 ± 4.94 vs 4.79 ± 3.93, p = 0.03 for SUVavg). Quantitative RGD PET parameters were significantly higher in the HER2-positive group (2.42 ± 0.59 vs 2.90 ± 0.75, p = 0.04 for SUVmax; 1.60 ± 0.38 vs 1.95 ± 0.53, p = 0.04 for SUVavg) and showed a significant positive correlation with the HER2/CEP17 ratio (r = 0.38, p = 0.03 for SUVmax and r = 0.46, p < 0.01 for SUVavg). FDG PET parameters showed significantly higher values in the ER/PR−,Her2− subgroup versus the ER/PR+,Her2− or ER/PR+,Her2+ subgroups, while RGD PET parameters showed significantly lower values in the ER/PR−,Her2− subgroup versus the other subgroups. There was no correlation between FDG and RGD PET parameters in the overall group. Only the ER/PR−,Her2− subgroup showed a significant positive correlation between FDG and RGD PET parameters (r = 0.59, p = 0.03 for SUVmax).

Conclusion

68Ga-RGD and 18F-FDG PET/CT are promising functional imaging modalities for predicting biomarkers and molecular phenotypes in breast cancer patients.

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Acknowledgement

This study was supported by a grant of the Korea Healthcare Technology R&D Project, Ministry for Health & Welfare, Republic of Korea (A070001 and A100716).

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea

    Hai-Jeon Yoon, Keon Wook Kang, In Kook Chun, Song Lee, Yun-Sang Lee, Jae Min Jeong, Dong Soo Lee & June-Key Chung

  2. Department of Radiology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea

    Nariya Cho & Woo Kyung Moon

  3. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea

    Seock-Ah Im

  4. Department of Pathology, Seoul National University College of Medicine, Seoul, Korea

    Kyeong Cheon Jung

  5. Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea

    Keon Wook Kang, Jae Min Jeong, June-Key Chung & Woo Kyung Moon

  6. The Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea

    Hai-Jeon Yoon, Keon Wook Kang, Song Lee, Jae Min Jeong, Dong Soo Lee, June-Key Chung & Woo Kyung Moon

  7. Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University College of Medicine, Seoul, Korea

    Yun-Sang Lee

  8. Cancer Research Institute, Seoul National University, Seoul, Korea

    Keon Wook Kang, Jae Min Jeong & June-Key Chung

  9. Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, Korea

    Dong Soo Lee

  10. Department of Molecular Biology, Dankook University, Yongin, Korea

    Sunjoo Jeong

  11. Department of Nuclear Medicine, Ewha Womans University School of Medicine, Seoul, Korea

    Hai-Jeon Yoon

  12. Department of Nuclear Medicine, Kangwon National University Hospital, Chuncheon, Kangwon-Do, Korea

    In Kook Chun

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  1. Hai-Jeon Yoon
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Correspondence to Keon Wook Kang or Woo Kyung Moon.

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Yoon, HJ., Kang, K.W., Chun, I.K. et al. Correlation of breast cancer subtypes, based on estrogen receptor, progesterone receptor, and HER2, with functional imaging parameters from 68Ga-RGD PET/CT and 18F-FDG PET/CT. Eur J Nucl Med Mol Imaging 41, 1534–1543 (2014). https://doi.org/10.1007/s00259-014-2744-4

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