Variations in 18F-FDG uptake in breast cancer depending on PET/CT acquisition position

Abstract Background Breast cancer is considered the most common type of cancer and the second leading cause of cancer-related death among women. The prognostic factors including histological type, tumor nuclear grade, tumor size, and preoperative tumor-nodes-metastasis (TNM), hormone receptor and immunohistochemical molecular markers in the specimens, define the prognosis and survival rate. Early diagnosis and accurate follow-up of these patients affect the management. 18F-fluoro-2-deoxy-d-glucose positron emission tomography (FDG PET) has proved to be an effective and accurate imaging technique for a variety of diagnostic oncology tasks in breast cancer, lymph node staging, staging and restaging of recurrent and metastatic disease, and treatment follow up. Sufficient knowledge of the initial characteristics of breast tumors that may affect 18F-FDG uptake is essential for optimal use and interpretation of 18FFDG PET/CT imaging. Several pioneering studies have investigated the correlation between the affinity to 18F-FDG uptake and some of the histological and biological characteristics such as tumor type, grade, hormonal receptor status and HER2 status. Objective To correlate the relation of 18F-fluoro-2-deoxy-D-gIucose (18F-FDG) positron emission tomography/ computed tomography (PET/CT) uptake in breast cancer to histopathological and biological characteristics. Methods A prospective descriptive study over the course of 6 months from August 2019 till February 2020. It included twenty five patients with pathologically proven breast carcinoma referred to the Radiology department, Ain Shams University Hospitals/ Private centers for a preoperative 18FDG PET/CT scan. Results For the tumors in 25 women, the mean SUVmax was 4.75±2.55. Primary tumor 18FFDG uptake ratio was correlated with patients' age (P = 0.032), tumor size (P = 0.034), histological grade (P=O.OI 8), estrogen and progesterone negativity (P = 0.012), Her2/neu positivity (P = 0.012), high Ki-67 level (>10%) (P = 0.024), axillary lymph node involvement (P = 0.038) and distant metastasis (P = 0.039). High Ki-67 level (Pearson Correlation Coefficient= 0.457; 95% confidence interval; P = 0.037) and tumor size (Pearson Correlation Coefficient =0.458; 95% confidence interval, P = 0.021) were determining factors for high 18F-FDG uptake values. The histological type (P = 0.525) was not significantly correlated with 18F-FDG uptake. Conclusion FDG PET imaging was used to estimate tumor biologic behavior of breast cancer such as histopathologic grading, immunohistochemistry, axillary lymph node status and distant metastasis. SUVmax correlated with several of pathological prognostic factors may have potential for predicting the prognosis of breast cancer. 18F-FDG PET/CT could be a useful tool to pretherapeutically predict biological characteristics and baseline risk of breast cancer Increased 18FFDG uptake on PET/CT was correlated with a high Ki-67 proliferation index and larger tumor size. These results suggest a potential role of 18F-FDG PET/CT in identifying tumor aggressiveness.

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Correlation between 18F-FDG uptake on PET/CT and prognostic factors in triple-negative breast cancer

European Radiology ◽

10.1007/s00330-015-3734-z ◽

2015 ◽

Vol 25 (11) ◽

pp. 3314-3321 ◽

Cited By ~ 20

Author(s):

Hye Ryoung Koo ◽

Jeong Seon Park ◽

Keon Wook Kang ◽

Wonshik Han ◽

In Ae Park ◽

...

Keyword(s):

Breast Cancer ◽

Prognostic Factors ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Fdg Uptake ◽

Pet Ct ◽

18F Fdg

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Comparison of serum NEDD-9, CA 15-3, and CEA levels and PET metabolic parameters in breast cancer patients with 18 F-FDG PET / CT

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.66.5.673 ◽

2020 ◽

Vol 66 (5) ◽

pp. 673-679

Author(s):

Esra Arslan ◽

Hale Aral ◽

Tamer Aksoy ◽

Çiğdem Usul Afşar ◽

Senem Karabulut ◽

...

Keyword(s):

Breast Cancer ◽

Fdg Pet ◽

Serum Levels ◽

Breast Cancer Patients ◽

Ki 67 ◽

Fdg Uptake ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

The Relationship

SUMMARY OBJECTIVE Analyze the over expression of neural precursor cell expressed developmentally down-regulated protein 9 (NEDD-9) deregulated associated with a poor prognosis in various carcinomas. Our objective was to investigate the relationship between the levels of NEDD-9, CA 15-3, and CEA and PET (SUVmax, MTV40, TLG40) with the clinical parameters of patients with breast cancer (BC). METHODS One hundred and eleven patients (82 BC patients who underwent 18F-FDG PET/CT and 29 healthy controls) were evaluated. SUVmax, MTV, and TLG of the primary tumor were compared with the molecular and histopathological subtypes. 18F-FDG, MTV, and TLG were evaluated based on the clinical data, i.e., nodal involvement, distant metastasis, ER and PR status, Ki-67, serum levels of NEDD-9, CA15-3, and CEA. We compared the NEDD-9 in the BC and healthy control groups. RESULTS The mean ± SD of SUVmax in the 82 patients was 13.0 ± 8.6. A statistically significant relationship (p = 0.022) was found between the molecular subtypes and 18F-FDG uptake. The relationship between 18F-FDG uptake and TLG measured in patients <50 years, ER-PR negativity, and HER2 positivity were statistically significant (p=0.015, 0.007, 0.046, and 0.001, respectively). MTV40, TLG40, and CA 15-3 in metastatic patients were statistically significant (p=0.004, 0.005, and 0.003, respectively). NEDD-9 in the BC group was significantly higher than in the healthy group (p=0.017). There was a positive correlation between SUVmax and Ki67 and CA 15-3; MTV40 and CEA; CA 15-3, CEA, SUVmax, and MTV40; a negative correlation was found between CEA, TLG40, and age. CONCLUSION The use of SUVmax, MTV40, and TLG40 parameters with NEDD-9 and tumor markers has been shown to provide a high diagnostic, predictive, and prognostic value for the management of BC. This is considered to be the basis of interventions focused on the treatment objectives related to NEDD-9.

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[18F]FDG uptake of bone marrow on PET/CT for predicting distant recurrence in breast cancer patients after surgical resection

EJNMMI Research ◽

10.1186/s13550-020-00660-y ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Jeong Won Lee ◽

Sung Yong Kim ◽

Sun Wook Han ◽

Jong Eun Lee ◽

Hyun Ju Lee ◽

...

Keyword(s):

Breast Cancer ◽

Bone Marrow ◽

Cancer Patients ◽

Surgical Resection ◽

Distant Recurrence ◽

Breast Cancer Patients ◽

Fdg Uptake ◽

Pet Ct ◽

18F Fdg

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Diagnostic and Prognostic Value of 18F-FDG PET/CT in Male Breast Cancer: Results From a Bicentric Population

Current Radiopharmaceuticals ◽

10.2174/1874471008666150528111112 ◽

2016 ◽

Vol 9 (2) ◽

pp. 169-177 ◽

Cited By ~ 3

Author(s):

Laura Evangelista ◽

Francesco Bertagna ◽

Mattia Bertoli ◽

Tigu Stela ◽

Giorgio Saladini ◽

...

Keyword(s):

Breast Cancer ◽

Male Breast Cancer ◽

Fdg Pet ◽

Prognostic Value ◽

Male Breast ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Diagnostic And Prognostic Value

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18F-FDG Uptake on PET/CT in Transposed Ovaries

American Journal of Roentgenology ◽

10.2214/ajr.06.5004 ◽

2006 ◽

Vol 186 (1) ◽

pp. 267-268 ◽

Cited By ~ 2

Author(s):

R. Zissin ◽

E. Even-Sapir

Keyword(s):

Fdg Uptake ◽

Pet Ct ◽

18F Fdg

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Impacts of time interval on 18F-FDG uptake for PET/CT in normal organs

Medicine ◽

10.1097/md.0000000000013122 ◽

2018 ◽

Vol 97 (45) ◽

pp. e13122 ◽

Cited By ~ 3

Author(s):

Rang Wang ◽

Haotian Chen ◽

Chengzhong Fan

Keyword(s):

Time Interval ◽

Fdg Uptake ◽

Pet Ct ◽

18F Fdg

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Characteristics and Clinical Value of 18F-FDG PET/CT in the Management of Adult-Onset Still’s Disease: 35 Cases

Journal of Clinical Medicine ◽

10.3390/jcm10112489 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2489

Author(s):

Josselin Brisset ◽

Yvan Jamilloux ◽

Stephanie Dumonteil ◽

Guillaume Lades ◽

Martin Killian ◽

...

Keyword(s):

Bone Marrow ◽

Lymph Node ◽

Differential Diagnoses ◽

Adult Onset Still’S Disease ◽

Still’S Disease ◽

Clinical Value ◽

Fdg Uptake ◽

Pet Ct ◽

18F Fdg ◽

Adult Onset Still's Disease

While the diagnosis of adult-onset Still’s disease (AOSD) involves the exclusion of differential diagnoses, the characteristics and value of 18F-Fluorodeoxyglucose (18F-FDG) Positron Emission Tomography coupled with CT (PET/CT) in the management of AOSD remain poorly known. Our retrospective study included patients from four centers, fulfilling Yamaguchi or Fautrel criteria, who underwent a PET/CT during an active AOSD. Thirty-five patients were included. At the time of PET/CT, the Yamaguchi criteria were met in 23 of 29 evaluable cases. PET/CT showed bone marrow (74.3%), lymph node (74.3%), and splenic (48.6%) FDG uptake. Despite arthralgia or arthritis in most patients, joints were rarely the sites of 18F-FDG accumulation. The spatial distribution of 18F-FDG uptake was nonspecific, and its intensity could be similar to malignant disease. Lymph node or bone marrow biopsy was performed after PET/CT in 20 patients (57.1%). The intensity of bone marrow; splenic and lymph node hypermetabolism appeared to be correlated with disease activity. Abnormal PET/CT in the cervical lymph nodes and age ≥ 60 years seemed to be predictive factors for monocyclic evolution. The clinical value of PET/CT is not in direct diagnosis; but as an aid in excluding differential diagnoses by searching for their scintigraphic features and guiding biopsy.

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