Correlation of 18‐fluorodeoxyglucose uptake values on PET–CT scan with histological prognostic markers in breast cancer

Abstract

Background Positron emission tomography–computed tomography (PET‐CT) scan utilizes 18‐fluorodeoxyglucose (18‐FDG), based on the principle of higher glycolytic activity and reduced glucose‐6‐phosphatase levels in cancer cells. This imaging modality is usually advised in the metastatic evaluation of stage III breast cancer patients. The correlation of maximum standard uptake values of primary lesion with different pathological and molecular markers has not been studied extensively. Methods Retrospective analysis of the data was performed from our prospectively maintained breast cancer database. All the patients who had undergone 18‐FDG PET–CT scan at initial evaluation for staging between June 2017 and April 2020 were included in the study. One‐way ANOVA test or Student's t‐test as appropriate was performed to assess the difference of means in maximum standard uptake values (SUVmax) of the primary lesion and axillary nodes with clinical stage, histological grade, molecular subtype. Bonferroni post hoc test was also applied. Results Out of 388 patients in the breast cancer database, 45 patients met inclusion criteria. There was a significant correlation of molecular subtype (p = 0.029) with SUVmax of the primary lesion. Higher primary SUVmax was associated with higher T stage (p = 0.01) and higher histological grade (p = 0.06). In each molecular subtype, there was an increase in mean SUVmax of the primary lesion with increasing histological grade and vice versa. Conclusions SUVmax of the primary lesion in breast cancer patients reflects tumor biology. Higher SUVmax can predict patients with triple‐negative breast cancers and higher grades in primary tumors. However, further large‐scale validatory studies are essential.

The relationship between 18F-FDG PET/CT parameters and histopathological-immunohistochemical properties in breast cancer

“…While some of the studies were compatible with our results [16], most of them were conflicting with us. The highest SUVmax values were observed mostly in TN group in the literature [8,10,12,13,15,17].…”

“…It provides essential contributions to the clinical practice in therapy planning, assessing therapy response and recurrence determination [5,7]. There are many studies in the literature focused on the relationship between SUVmax and histopathological-immunohistochemical factors in BC [8][9][10][11][12]. The relationship between histopathological-immunohistochemical factors and PET/CT parameters such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG) are also recently mentioned in the literature [13].…”