Association between 18F-FDG uptake and molecular subtype of breast cancer

Kitajima, Kazuhiro; Fukushima, Kazuhito; Miyoshi, Yasuo; Nishimukai, Arisa; Hirota, Seiichi; Igarashi, Yoko; Katsuura, Takayuki; Maruyama, K.; Hirota, Shun

doi:10.1007/s00259-015-3070-1

Cited by 65 publications

(67 citation statements)

References 24 publications

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“…In patients with recently diagnosed BC, the baseline glycolytic activity on 18F-FDG PET/CT is associated with tumor biology. Evidence level II [47][48][49][50][51][52][53][54][55][56] (Table 8). Question (f): Does the metabolic information from a baseline 18F-FDG PET/CT have implications for the patient's prognosis?…”

Section: Resultsmentioning

confidence: 99%

18F-FDG PET/CT in breast cancer: Evidence-based recommendations in initial staging

et al. 2017

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Current guidelines do not systematically recommend 18F-FDG PET/CT for breast cancer staging; and the recommendations and level of evidence supporting its use in different groups of patients vary among guidelines. This review summarizes the evidence about the role of 18F-FDG PET/CT in breast cancer staging and the therapeutic and prognostic impact accumulated in the last decade. Other related aspects, such as the association of metabolic information with biology and prognosis are considered and evidence-based recommendations for the use of 18F-FDG PET/CT in breast cancer staging are offered. We systematically searched MEDLINE for articles reporting studies with at least 30 patients related to clinical questions following the Problem/Population, Intervention, Comparison, and Outcome framework. We critically reviewed the selected articles and elaborated evidence tables structuring the summarized information into methodology, results, and limitations. The level of evidence and the grades of recommendation for the use of 18F-FDG PET/CT in different contexts are summarized. Level III evidence supports the use of 18F-FDG PET/CT for initial staging in patients with recently diagnosed breast cancer; the diagnostic and therapeutic impact of the 18F-FDG PET/CT findings is sufficient for a weak recommendation in this population. In patients with locally advanced breast cancer, level II evidence supports the use of 18F-FDG PET/CT for initial staging; the diagnostic and therapeutic impact of the 18F-FDG PET/CT findings is sufficient for a strong recommendation in this population. In patients with recently diagnosed breast cancer, the metabolic information from baseline 18F-FDG PET/CT is associated with tumor biology and has prognostic implications, supported by level II evidence. In conclusion, 18F-FDG PET/CT is not recommended for staging all patients with early breast cancer, although evidence of improved regional and systemic staging supports its use in locally advanced breast cancer. Baseline tumor glycolytic activity is associated with tumor biology and prognosis.

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Section: Resultsmentioning

confidence: 99%

18F-FDG PET/CT in breast cancer: Evidence-based recommendations in initial staging

et al. 2017

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“…FDG uptake, on the other hand, is correlated with molecular subtype, i.e., luminal A, luminal B (HER2-negative), luminal B (HER2-positive), HER2 positivity and triple-negativity [16,17]. Kitajima et al [17] have demonstrated that the triple-negative subtype and HER2-positive subtype show a higher SUV max , whereas the luminal A subtype often shows a lower SUV max .…”

Section: Factors Correlated With Fdg Uptake In Primary Breast Tumorsmentioning

confidence: 99%

“…Kitajima et al [17] have demonstrated that the triple-negative subtype and HER2-positive subtype show a higher SUV max , whereas the luminal A subtype often shows a lower SUV max . They also reported that a cut-off value of 3.60 yielded a sensitivity of 70 % and a specificity of 66 % for predicting that a tumor was of the luminal A subtype, and that a cut-off value of 6.75 yielded a sensitivity of 65 % and a specificity of 75 % for predicting a HER2-positive subtype.…”

Section: Factors Correlated With Fdg Uptake In Primary Breast Tumorsmentioning

confidence: 99%

“…Many groups have demonstrated good correlations between primary tumor FDG uptake on PET/CT, expressed as the maximum standardized uptake value (SUV max ), and clinicopathological findings that are known to be important prognostic indicators in breast cancer patients [10][11][12][13][14][15][16][17]. A higher SUV max is reported to be significantly associated with estrogen receptor (ER) negativity, progesterone receptor (PR) negativity, human epidermal growth factor receptor 2 (HER2) positivity, a high Ki-67 index, a bigger tumor size, a higher histological grade, presence of axillary lymph node (LN) metastasis, and a higher stage.…”

Section: Factors Correlated With Fdg Uptake In Primary Breast Tumorsmentioning

confidence: 99%

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Present and future role of FDG-PET/CT imaging in the management of breast cancer

Kitajima

Miyoshi

2016

Jpn J Radiol

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by malignant cells, opened a new field in clinical oncologic imaging. Recently, integrated positron emission tomography/computed tomography (PET/CT), in which a full-ringdetector clinical PET scanner and multidetector-row helical CT scanner are combined, has made it possible to acquire both metabolic and anatomic imaging data using a single device in a single diagnostic session, and provides precise anatomic localization of suspicious areas of increased FDG uptake. When used in a clinical setting, FDG-PET/CT leads to a significant improvement in diagnostic accuracy and has had a considerable impact on patient management, including diagnosis, initial staging, optimization of treatment, restaging, monitoring of the response to therapy, and prognostication of various malignant tumors. We herein review the current and future roles of FDG-PET/CT in the management of breast cancer, discussing its usefulness and limitations for imaging in these patients. DiagnosisFDG-PET imaging has poor sensitivity (<50 %) for subcentimeter breast cancers [9,10]. This is due to the limited spatial resolution of PET and, in some cases, by tumor characteristics (e.g., low FDG avidity in grade 1 cancer, ductal carcinoma in situ, or lobular carcinoma) [1,2]. Specificity can also be altered by variations of FDG uptake in certain benign conditions, such as infection, fibroadenoma, ductal adenoma, inflammatory granulomatous mastitis, and fibrocystic changes [3].In order to improve specificity, some authors would obtain a second series of PET images centered on the breast approximately 2 h after FDG injection (dual-time imaging) [4]. Indeed, FDG uptake seems to increase with time in the case of malignancy, while some inflammatory lesions show stable or decreasing uptake [4]. However, dual-time Abstract Integrated positron emission tomography/computed tomography (PET/CT) with 2-[18F]fluoro-2-deoxyd-glucose (FDG) is a useful tool for acquisition of both glucose metabolic and anatomic imaging data using a single device in a single diagnostic session, and has opened a new field in clinical oncologic imaging. FDG-PET/CT has been used successfully for the diagnosis, initial staging, restaging, early treatment response assessment, evaluation of metastatic disease response, and prognostication of breast cancer as well as various malignant tumors. We herein review the current place and role of FDG-PET/CT in the management of breast cancer, focusing on its usefulness and limitations in the imaging of these patients.

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“…A number of studies have demonstrated a correlation between FDG accumulation on PET/CT and pathological characteristics. The maximum standardized uptake value (SUVmax) can be an independent prognostic factor, and high levels of FDG accumulation indicate more aggressive proliferation potential in breast cancers [8]- [13]. Moreover, several authors have demonstrated that FDG accumulation might be a good predictor for HER2 overexpressing and triple-negative molecular subtypes [12] [13] [14] [15].…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of SUVmax of <sup>18</sup>F-FDG PET/CT in Early Stage Breast Cancer with No LN Metastasis

Murakami¹,

Fukushima²,

Tani³

et al. 2017

OJMI

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Purpose: To investigate the correlation between SUVmax of FDG-PET/CT and pathological findings including prognostic factors in early-stage T1-T2 breast cancer patients with no LN metastasis. Materials and Methods: This retrospective study investigated 75 patients (mean age 58.9 years; age range 30 -82 years) with invasive breast cancer who underwent FDG-PET/CT for preoperative staging. All patients underwent subsequent surgery without prior neoadjuvant chemotherapy or endocrine therapy, and those who were confirmed to have T1-or T2-stage by histopathology with no LN metastasis were included. Two patients who had no perceptible FDG accumulation on PET/CT scans were excluded. The correlations between the SUVmax of the tumor and the pathological and immunohistochemical data were evaluated. Results: The mean SUVmax for the total 73 tumors was 5.46 ± 4.05. The mean SUVmax was 3.95 ± 3.28 for the T1 stage group (n = 36) and 7.23 ± 4.10 (p < 0.001) for the T2 stage group (n = 37). A high SUVmax was significantly associated with high nuclear grade (p < 0.001), negative hormone receptor status (p < 0.001), positive HER2 status (p = 0.008), and high Ki-67 status (p < 0.001), respectively. Conclusion: In T1-T2 breast cancer with no LN metastasis, the SUVmax of FDG-PET/CT had significant positive relationships with several prognostic parameters of pathological status. Even in early-stage breast cancer patients, pretreatment FDG-PET/CT is useful for predicting malignant behavior and prognosis).

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Association between 18F-FDG uptake and molecular subtype of breast cancer

Abstract: SUVmax, a metabolic semiquantitative parameter, shows a significant correlation with the molecular subtype of breast cancer, and is useful for predicting the luminal A or HER2-positive subtype.

Cited by 65 publications

References 24 publications

18F-FDG PET/CT in breast cancer: Evidence-based recommendations in initial staging

18F-FDG PET/CT in breast cancer: Evidence-based recommendations in initial staging

Present and future role of FDG-PET/CT imaging in the management of breast cancer

Prognostic Value of SUVmax of <sup>18</sup>F-FDG PET/CT in Early Stage Breast Cancer with No LN Metastasis

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Association between 18F-FDG uptake and molecular subtype of breast cancer

Abstract: SUVmax, a metabolic semiquantitative parameter, shows a significant correlation with the molecular subtype of breast cancer, and is useful for predicting the luminal A or HER2-positive subtype.

Cited by 65 publications

References 24 publications

18F-FDG PET/CT in breast cancer: Evidence-based recommendations in initial staging

18F-FDG PET/CT in breast cancer: Evidence-based recommendations in initial staging

Present and future role of FDG-PET/CT imaging in the management of breast cancer

Prognostic Value of SUVmax of &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/CT in Early Stage Breast Cancer with No LN Metastasis

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Prognostic Value of SUVmax of <sup>18</sup>F-FDG PET/CT in Early Stage Breast Cancer with No LN Metastasis