Relationship between Prognostic Stage in Breast Cancer and Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

Abstract

This retrospective study examined the relationship between the standardized uptake value max (SUVmax) of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and the prognostic stage of breast cancer. We examined 358 breast cancers in 334 patients who underwent 18F-FDG PET/CT for initial staging between January 2016 and December 2019. We extracted data including SUVmax of 18F-FDG PET and pathological biomarkers, including estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and nuclear grade. Anatomical and prognostic stages were determined per the American Joint Committee on Cancer (eighth edition). We examined whether there were statistical differences in SUVmax between each prognostic stage. The mean SUVmax values for clinical prognostic stages were as follow: stage 0, 2.2 ± 1.4; stage IA, 2.6 ± 2.1; stage IB, 4.2 ± 3.5; stage IIA, 5.2 ± 2.8; stage IIB, 7.7 ± 6.7; and stage III + IV, 7.0 ± 4.5. The SUVmax values for pathological prognostic stages were as follows: stage 0, 2.2 ± 1.4; stage IA, 2.8 ± 2.2; stage IB, 5.4 ± 3.6; stage IIA, 6.3 ± 3.1; stage IIB, 9.2 ± 7.5, and stage III + IV, 6.2 ± 5.2. There were significant differences in mean SUVmax between clinical prognostic stage 0 and ≥II (p < 0.001) and I and ≥II (p < 0.001). There were also significant differences in mean SUVmax between pathological prognostic stage 0 and ≥II (p < 0.001) and I and ≥II (p < 0.001). In conclusion, mean SUVmax increased with all stages up to prognostic stage IIB, and there were significant differences between several stages. The SUVmax of 18F-FDG PET/CT may contribute to prognostic stage stratification, particularly in early cases of breast cancers.

Clinicopathological and molecular predictors of [18F]FDG-PET disease detection in HER2-positive early breast cancer: RESPONSE, a substudy of the randomized PHERGain trial

“…The median SUVmax at baseline in our entire analyzed population was 7.2 (range 1-39.3), which is similar to previous studies including patients with HER2+ tumors [19,27]. Additionally, our findings are in line with previous studies in patients with EBC that have demonstrated a relationship between SUVmax and several classical clinicopathological characteristics such as clinical stage [14], HR status [15,16], Ki67 proliferation index [11,17], tumor size [18], and histological grade [19][20][21] regardless of BC subtype. Nevertheless, our results are of particular interest because they were specifically generated in patients with HER2+ tumors.…”

“…The clinical, pathological, and molecular characteristics of these screening failures need to be investigated in order to guide more adequate patient selection. Numerous studies have reported an association between tumor [ 18 F] FDG uptake in [ 18 F]FDG-PET and both molecular subtypes of BC, as well as clinicopathological characteristics [11,[13][14][15][16][17][18][19][20][21][22].…”

Joint EANM-SNMMI guideline on the role of 2-[18F]FDG PET/CT in no special type breast cancer

“…PET has limited spatial resolution (approximately 5-6 mm) and its performance is inferior to that of the sentinel node biopsy [88]. SUVmax values are lower in stage I than in higher stages [89]. In addition, the risk of distant metastases in T1N0 disease (stage I) is very low and PET imaging may lead to false positive findings.…”

Proposal to Improve the Image Quality of Short-Acquisition Time-Dedicated Breast Positron Emission Tomography Using the Pix2pix Generative Adversarial Network

“…[ 18 F]fluorodeoxyglucose ( 18 F-FDG) positron emission tomography (PET)/computed tomography (CT) is widely used for identifying distant metastases and secondary cancers, staging and monitoring treatment response [ 2 , 3 , 4 ]. In addition, some studies have reported using PET/CT for predicting the prognosis of patients with BC [ 5 , 6 ].…”