Association of 18F-FDG PET/CT textural features with immunohistochemical characteristics in invasive ductal breast cancer

Önner, Hasan; Coşkun, Nazım; Erol, Mustafa; Karanis, Meryem İlkay Eren

doi:10.1016/j.remnie.2020.12.009

Cited by 5 publications

(3 citation statements)

References 27 publications

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“…Li et al ( 27 ) found that skewness was the most ideal predictor for pelvic lymph node involvement in cervical squamous cell carcinoma. Our previous study revealed that a high-order TF showing the distribution of short homogeneous regions with low gray levels had an independent association with axillary lymph node metastasis unlike other parameters of 18 F-FDG PET/CT in invasive ductal breast cancer ( 28 ).…”

Section: Discussionmentioning

confidence: 95%

The Role of Histogram-Based Textural Analysis of <sup>18</sup>F-FDG PET/CT in Evaluating Tumor Heterogeneity and Predicting the Prognosis of Invasive Lung Adenocarcinoma

Önner¹,

Coşkun²,

Erol³

et al. 2022

Mirt

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Objectives: This study aimed to investigate the contributory role of histogram-based textural features (HBTFs) extracted from 18 fluorinefluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) in tumoral heterogeneity (TH) evaluation and invasive lung adenocarcinoma (ILA) prognosis prediction. Methods: This retrospective study analyzed the data of 72 patients with ILA who underwent 18 F-FDG PET/CT followed by surgical resection. The maximum standardized uptake value (SUV max ), metabolic tumor volume, and total lesion glycolysis values were calculated for each tumor. Additionally, HBTFs were extracted from 18 F-FDG PET/CT images using the software program. ILA was classified into the following five histopathological subtypes according to the predominant pattern: Lepidic adenocarcinoma (LA), acinar adenocarcinoma, papillary adenocarcinoma, solid adenocarcinoma (SA), and micropapillary adenocarcinoma (MA). Differences between 18 F-FDG PET/CT parameters and histopathological subtypes were evaluated using non-parametric tests. The study endpoints include overall survival (OS) and progression-free survival (PFS). The prognostic values of clinicopathological factors and 18 F-FDG PET/CT parameters were evaluated using the Cox regression analyses. Results: The median SUV max and entropy values were significantly higher in SA-MA, whereas lower in LA. The median energy-uniformity value of the LA was significantly higher than the others. Among all parameters, only skewness and kurtosis were significantly associated with lymph node involvement status. The median values for follow-up time, PFS, and OS were 31.26, 16.07, and 20.87 months, respectively. The univariate Cox regression analysis showed that lymph node involvement was the only significant predictor for PFS. The multivariate Cox regression analysis revealed that higher SUV max (≥11.69) and advanced stage (IIB-IIIA) were significantly associated with poorer OS [hazard ratio (HR): 3.580, p=0.024 and HR: 7.608, p=0.007, respectively]. Conclusion: HBTFs were tightly associated with clinicopathological factors causing TH. Among the 18 F-FDG PET/CT parameters, only skewness and kurtosis were associated with lymph node involvement, whereas SUV max was the only independent predictor of OS. TH measurement with HBTFs may contribute to conventional metabolic parameters in guiding precision medicine for ILA.

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Section: Discussionmentioning

confidence: 95%

The Role of Histogram-Based Textural Analysis of <sup>18</sup>F-FDG PET/CT in Evaluating Tumor Heterogeneity and Predicting the Prognosis of Invasive Lung Adenocarcinoma

Önner¹,

Coşkun²,

Erol³

et al. 2022

Mirt

Self Cite

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“…Previous investigation has reported the relationship between the uptake of [ 18 F]FDG and breast cancer subtype [27]. Therefore, our study also explored the relationship between [ 68 Ga]Ga-FAPI uptake and clinicopathologic characteristics (receptor status and breast phenotypes) in primary and metastatic breast cancer.…”

Section: Discussionmentioning

confidence: 97%

Gallium-68-Labelled Fibroblast Activation Protein Inhibitor PET/CT in the clinical diagnosis and management of breast cancer: Comparison with [18F]FDG PET/CT

Guo

Fan

et al. 2022

Preprint

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Purpose To evaluate the diagnostic accuracy and clinical impact of gallium-68-labelled fibroblast activation protein inhibitor ([68Ga]Ga-FAPI) PET/CT in primary and metastatic breast cancer and compare the results with those of standard-of-care imaging (SCI) and [18F]Fluorodeoxyglucose (FDG) PET/CT. Methods Patients with diagnosed or suspected breast cancer who underwent concomitant [68Ga] Ga-FAPI (FAPI-46) and [18F]FDG PET/CT scans from October 2019 to March 2022 were retrospectively analysed. Breast ultrasound (US) imaging was performed in all treatment-naïve patients as SCI. The maximum standard uptake value (SUVmax), tumour-to-background ratio (TBR), lesion detection rate, and tumour-node-metastasis (TNM) classifications between [68Ga]Ga-FAPI and [18F]FDG PET/CT were evaluated, and compared. Results Twenty-eight women (median age, 52.5 y; range, 28–80 y) were included. Among them, 5 patients underwent evaluation for a definitive diagnosis of suspected breast lesions, 9 underwent initial staging, and 14 were evaluated for the detection of recurrence. The sensitivities of breast US, [18F]FDG, and [68Ga]Ga-FAPI PET/CT for detecting primary breast tumours were 80%, 70%, and 100%, respectively. Regarding the diagnosis of recurrent/metastatic lesions, the per-lesion detection rate of [68Ga]Ga- FAPI PET/CT was significantly higher than that of [18F]FDG, which including local and regional recurrence (128 vs. 88), neck lymph node (LN) metastases (33 vs. 15), abdomen LN metastases (28 vs. 3), bone metastases (146 vs. 59), and liver metastases (28 vs. 11). Compared with [18F]FDG, [68Ga]Ga-FAPI PET/CT upstaged five patients’ TNM staging/re-staging (7/27, 26%) and changed five patients’ clinical management (5/27, 19%). Compared to SCI, [68Ga]Ga-FAPI upstaged ten patients' TNM staging/re-staging (9/27, 33%) and changed the therapeutic regimen of seven patients (7/27, 26%). There was no significant association between FAPI-derived SUVmax and receptor status/histologic type in both primary and metastatic lesions. Conclusion [68Ga]Ga-FAPI PET/CT was superior to [18F]FDG in diagnosing primary and metastatic breast cancer, with higher radiotracer uptake and TBR, especially in the detection of primary/recurrent tumour, abdominal LN metastases, liver, and bone metastases. [68Ga]Ga-FAPI PET/CT is superior to [18F]FDG and SCI in TNM staging and may improve tumour staging, recurrence detection, and implementation of necessary treatment modifications.

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“…Recently, the WB-PET-based radiomics model showed promising results in predicting occult lymph node metastasis in cN0 tumors, including lung cancer, cervical cancer, and esophageal adenocarcinoma [ 25 , 26 , 27 ]. Hasan et al analyzed the textural features of WB-PET/CT coming from 124 breast cancer patients and showed the gray-level zone length matrix (GLZLM) could be the predictive parameter of ALN, but the AUC was only 0.64 [ 28 ]. Similarly, in the study by Bong [ 29 ], the primary tumor of 100 invasive ductal BC patients was analyzed using the WB-PET/CT-based radiomics model to predict ALN status.…”

Section: Discussionmentioning

confidence: 99%

Development of High-Resolution Dedicated PET-Based Radiomics Machine Learning Model to Predict Axillary Lymph Node Status in Early-Stage Breast Cancer

Cheng

Ren²,

et al. 2022

Cancers

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Purpose of the Report: Accurate clinical axillary evaluation plays an important role in the diagnosis and treatment planning for early-stage breast cancer (BC). This study aimed to develop a scalable, non-invasive and robust machine learning model for predicting of the pathological node status using dedicated-PET integrating the clinical characteristics in early-stage BC. Materials and Methods: A total of 420 BC patients confirmed by postoperative pathology were retrospectively analyzed. 18F-fluorodeoxyglucose (18F-FDG) Mammi-PET, ultrasound, physical examination, Lymph-PET, and clinical characteristics were analyzed. The least absolute shrinkage and selection operator (LASSO) regression analysis were used in developing prediction models. The characteristic curve (ROC) of the area under receiver-operator (AUC) and DeLong test were used to evaluate and compare the performance of the models. The clinical utility of the models was determined via decision curve analysis (DCA). Then, a nomogram was developed based on the model with the best predictive efficiency and clinical utility and was validated using the calibration plots. Results: A total of 290 patients were enrolled in this study. The AUC of the integrated model diagnosed performance was 0.94 (95% confidence interval (CI), 0.91–0.97) in the training set (n = 203) and 0.93 (95% CI, 0.88–0.99) in the validation set (n = 87) (both p < 0.05). In clinical N0 subgroup, the negative predictive value reached 96.88%, and in clinical N1 subgroup, the positive predictive value reached 92.73%. Conclusions: The use of a machine learning integrated model can greatly improve the true positive and true negative rate of identifying clinical axillary lymph node status in early-stage BC.

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Association of 18F-FDG PET/CT textural features with immunohistochemical characteristics in invasive ductal breast cancer

Cited by 5 publications

References 27 publications

The Role of Histogram-Based Textural Analysis of <sup>18</sup>F-FDG PET/CT in Evaluating Tumor Heterogeneity and Predicting the Prognosis of Invasive Lung Adenocarcinoma

The Role of Histogram-Based Textural Analysis of <sup>18</sup>F-FDG PET/CT in Evaluating Tumor Heterogeneity and Predicting the Prognosis of Invasive Lung Adenocarcinoma

Gallium-68-Labelled Fibroblast Activation Protein Inhibitor PET/CT in the clinical diagnosis and management of breast cancer: Comparison with [18F]FDG PET/CT

Development of High-Resolution Dedicated PET-Based Radiomics Machine Learning Model to Predict Axillary Lymph Node Status in Early-Stage Breast Cancer

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