Associations between the standardized uptake value of 18F-FDG PET/CT and the prognostic factors of invasive lobular carcinoma: in comparison with invasive ductal carcinoma

Abstract

BackgroundThe aims of this study were to evaluate the associations between the maximum standardized uptake value (SUVmax) and prognostic factors in invasive lobular carcinoma (ILC) and to compare these results with those in invasive ductal carcinoma (IDC).MethodsThe study included pathologically confirmed ILCs (n = 32) and IDCs (n = 73). We retrospectively evaluated the preoperative 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and measured the SUVmax. The pathologic results were reviewed regarding the size, histological type, histological grade, estrogen receptor (ER) and progesterone receptor (PR) status, human epidermal growth factor receptor 2 (HER2), epidermal growth factor receptor (EGFR), and Ki-67 of the primary tumor. We also compared the associations between the SUVmax and prognostic factors.ResultsThe mean SUVmax of the ILCs was significantly lower compared with that of the IDCs (P = 0.032). The SUVmax increased with tumor grade (P < 0.001) and was higher with ER negativity compared with ER positivity (P = 0.007) in IDC. The SUVmax was higher with EGFR positivity compared with EGFR negativity (P = 0.013) in IDC and higher with Ki-67 positivity compared with Ki-67 negativity in IDC and ILC (P < 0.001 and P = 0.002, respectively). The SUVmax was not significantly different regarding PR or HER2 for both tumor groups. The correlation between the tumor size and the SUVmax was demonstrated for IDCs (r = 0.57), but not for ILCs (r = 0.25).ConclusionsThe SUVmax was significantly different according to the tumor grade, ER, EGFR, and Ki-67 for IDCs. The SUVmax exhibited a positive association with Ki-67 in ILC; however, it was not significantly different with other factors, which suggests that the role of 18F-FDG PET/CT may be limited in ILC.

Initial Fludeoxyglucose (18F) Positron Emission Tomography-Computed Tomography (FDG-PET/CT) Imaging of Breast Cancer – Correlations with the Primary Tumour and Locoregional Metastases

“…Furthermore, significant correlations between tumour size and the size of metastatic axillary LNs, SUV max -T and size of metastatic axillary LNs, SUV max -T and SUV max -LN were found in our LABC group. Primary tumour size was stated to be predictive of metastatic involvement of axillary LNs [33], SUV max -T was reported to increase with tumor grade [15, 17, 39] and strong relationships were found among SUV max values, BC size and metastatic involvement of axillary LNs [40]. Similarly, the correlations in our LABC group also indicate that PET/CT parameters of the primary BC mass have prominent effect on the parameters of metastatic axillary LNs.…”

“…Quantification of FDG uptake in breast tumors provide objective criteria to differentiate malignant tissue [38]. In recent years, several PET/CT studies have been performed to determine SUV max values of the primary tumour in BC patients, which is an important predictor of tumour behaviour [15,17,39–41]. In a study including primary BC patients, researchers found that primary tumour FDG uptake (SUV max ) was significantly higher in tumours which had an unfavourable prognosis [41].…”

The value of 18F-FDG PET/CT imaging in breast cancer staging

“…Previously, it was indicated that FDG avidity of a breast cancer lesion depends on multiple factors [13]. One of these factors is the histological type of the tumor, where ILCs are known to have lower FDG avidity [14,15]. Although the number of patients in each of our histological subgroup was not identical, the SUVmax was significantly higher in IDC and IBC groups compared to ILC and IDC + ILC tumors.…”

Positron emission tomography in breast cancer: 18F- FDG and other radiopharmaceuticals

“…Associations between SUV and clinicopathological features and immunohistochemical factors have been demonstrated in previous studies. Jung et al (2015) evaluated the associations between the maximum SUV (SUVmax) and prognostic factors in ILC, comparing these results with those in IDC. In particular, regarding the histological subtype they observed that the lowest mean SUV max was found among patients with ILCs in comparison with IDCs tumors.…”

“…Finally, both PR and HER-2 status did not indicate any significant difference given the SUV max uptake between ILCs and IDCs tumor groups. (Jung et al, 2015).…”