Role of 18F-FDG PET/CT in evaluating molecular subtypes and clinicopathological features of primary breast cancer

Arslan, Esra; Çermik, Tevfik Fikret; Trabulus, Fadime Didem Can; Talu, Esra; Başaran, Şerife

doi:10.1097/mnm.0000000000000856

Cited by 31 publications

(29 citation statements)

References 23 publications

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“…8 In our previous study, we found significant association between 18F-FDG SUV max value and tumour stage, ER-PR expression, LN involvement and DOM in BC. 2 In the present study, increased SUV max showed statistically significant association with increased tumour diameter (>2 cm), high Ki-67 (>15%), and DOM. There was also significant association between molecular subtypes and SUV max .…”

Section: Discussionsupporting

confidence: 59%

“…18F‐fluoro‐2‐deoxy‐glucose positron emission tomography/computed tomography (18F‐FDG PET/CT) has proven predictive in value for BC staging/re‐staging. It is also valuable for evaluating treatment response with assessment of regional LN involvement, distant metastasis and recurrence 2,3 . However, the method has some known technical and patient‐related limitations.…”

Section: Introductionmentioning

confidence: 99%

“…It is also valuable for evaluating treatment response with assessment of regional LN involvement, distant metastasis and recurrence. 2,3 However, the method has some known technical and patient-related limitations. For instance, false positivity may be observed in infection and inflammation, and false negativity may be observed in some subtypes displaying low 18F-FDG uptake pattern.…”

Section: Introductionmentioning

confidence: 99%

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Alternative volumetric PET parameters for evaluation of breast cancer cases with 18F‐FDG PET/CT imaging: Metabolic tumour volume and total lesion glycolysis

Arslan¹,

Trabulus²,

Mermut³

et al. 2020

J Med Imag Rad Onc

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Introduction We aimed to investigate the prognostic and clinical values of two volumetric PET parameters used in conjunction with SUVmax at different thresholds in invasive ductal carcinoma (IDC). Methods A total of 139 metastatic IDC BC who underwent 18F‐FDG PET/CT imaging were included to study. MTV and TLG (40%, 50%, 60% and 70%) used in conjunction with primary tumour SUVmax. Nodal involvement, distant metastasis, ER, PR, Ki‐67 expression and survival data evaluated by comparing FDG PET parameters. Results Mean ± SD SUVmax of lesions (n = 139) was 13.97 ± 9.21. Primary tumour 18F‐FDG uptake associated increased tumour diameter (>2 cm), high Ki‐67 (>15%) and distant organ metastasis (DOM) (P = 0.015, 0.005 and 0.016, respectively). There was significant association between molecular subtypes and SUVmax (P = 0.002). High MTV associated with tumour diameter (MTV 40–70%), axillary lymph node (ALN) diameter (MTV 40–70%), and distant nodal metastasis (DNM) (MTV 50–70%). High TLG associated with tumour diameter (TLG 40–70%), high Ki‐67 (TLG 40–70%), ALN metastasis (TLG 40%), ALN diameter (TLG 40–70%) and DNM (TLG 40–70%). Median survival found shorter in DOM patients (P = 0.030, Log Rank = 0.110). Conclusion We think evaluation of MTV and TLG at different thresholds in addition to SUVmax would enhance diagnostic and prognostic value of 18F‐FDG PET/CT, and thus contribute to disease management.

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Section: Discussionsupporting

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Alternative volumetric PET parameters for evaluation of breast cancer cases with 18F‐FDG PET/CT imaging: Metabolic tumour volume and total lesion glycolysis

Arslan¹,

Trabulus²,

Mermut³

et al. 2020

J Med Imag Rad Onc

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“…Several previous studies demonstrated that the higher 18 F-FDG uptake of the primary breast lesion could mean a higher incidence of ALN metastasis (8,(34)(35)(36). Other studies however revealed no signi cant difference between MALN and BALN in terms of primary breast mass in 18 F-FDG PET/CT (37,38), which was also found in the present study for both 18 There are some limitations in the present study. Particularly, the number of cases is not large enough.…”

Section: Semi-quantitative Assessment Findingssupporting

confidence: 62%

18F-Alfatide II for the evaluation of axillary lymph nodes in breast cancer patients: comparison with 18F-FDG

Tian

Zhang

et al. 2021

Preprint

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18F-Alfatide II has been translated into clinical use and been proven to have good performance in identifying breast cancer. In this study, we investigated 18F-Alfatide II for evaluation of axillary lymph nodes (ALN) in breast cancer patients and compared the performances with 18F-FDG. Methods: A total of 44 female patients with clinically suspected breast cancer were enrolled and underwent 18F-Alfatide II and 18F-FDG PET/CT within a week. Tracer uptakes in ALN were evaluated by visual analysis, semiquantitative analysis with maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean) and SUVmax ratio of target/non-target (T/NT). Results: Among 44 patients, 37 patients were pathologically diagnosed with breast cancer with metastatic (17 cases) or non-metastatic (20 cases) ALN. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of visual analysis were 70.59%, 90.00%, 81.08%, 85.71% and 78.26% for 18F-Alfatide II, 64.71%, 90.00%, 78.38%, 84.62% and 75.00% for 18F-FDG, respectively. By combining 18F-Alfatide II and 18F-FDG, the sensitivity significantly increased to 82.35%, the specificity was 85.00%, the accuracy increased to 83.78%, the PPV was 82.35% and the NPV significantly increased to 85.00%. Three cases of luminal B subtype were false negative for both 18F-Alfatide II and 18F-FDG. The other 2 false negative cases of 18F-Alfatide II were triple-negative subtype and 3 false negative cases of 18F-FDG were luminal B subtype too. The AUCs of three semi-quantitative parameters (SUVmax, SUVmean, T/NT) for 18F-Alfatide II were between 0.8 and 0.9, whereas those for 18F-FDG were more than 0.9. 18F-Alfatide II T/NT had the highest Youden index (76.5%), specificity (100%), accuracy (89.19%) and PPV (100%) among these semi-quantitative parameters. 18F-Alfatide II uptake as well as 18F-FDG uptake in metastatic axillary lymph nodes (MALN) was significantly higher than that in benign axillary lymph nodes (BALN). Both 18F-Alfatide II and 18F-FDG did not show difference in primary tumor uptake irrespective of ALN status. Conclusion: 18F-Alfatide II can be used in breast cancer patients to detect metastatic ALN, however, like 18F-FDG, with high specificity but relatively low sensitivity. The combination of 18F-Alfatide II and 18F-FDG can significantly improve sensitivity and NPV. 18F-Alfatide II T/NT may serve as the most important semi-quantitative parameter to evaluate ALN.

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“…Additionally, PET/ CT is clinically indicated only for stage III breast cancer patients and so stage I and II breast cancers, which represent the majority, have been excluded from the analysis of these retrospective datasets. Radiogenomic analyses to date have principally focused on metabolic activity parameters of the primary tumor, most commonly via analysis of the maximum standardized uptake values, but also via analysis of the metabolic tumor volume and total lesion glycolysis (30)(31)(32)(33)(34)(35)(36)(37)(38)(39). While more advanced metrics such as histogram-based features have only recently been explored (30).…”

Section: Fdg Pet/ctmentioning

confidence: 99%

Breast Cancer Radiogenomics: Current Status and Future Directions

Grimm

Mazurowski

2020

Academic Radiology

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Role of 18F-FDG PET/CT in evaluating molecular subtypes and clinicopathological features of primary breast cancer

Abstract: Increased primary tumor F-FDG uptake was associated with aggressive molecular subtypes in this study. The relationship of distant nodal and organ metastasis with primary tumor SUVmax showed that increased F-FDG uptake is important in terms of management of therapy and prognosis.

Cited by 31 publications

References 23 publications

Alternative volumetric PET parameters for evaluation of breast cancer cases with 18F‐FDG PET/CT imaging: Metabolic tumour volume and total lesion glycolysis

Alternative volumetric PET parameters for evaluation of breast cancer cases with 18F‐FDG PET/CT imaging: Metabolic tumour volume and total lesion glycolysis

18F-Alfatide II for the evaluation of axillary lymph nodes in breast cancer patients: comparison with 18F-FDG

Breast Cancer Radiogenomics: Current Status and Future Directions

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