Evaluation of the Histopathological Features of Early-stage Invasive Ductal Breast Carcinoma by ¹⁸Fluoride-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

Abstract

Objectives: This study investigates the relationship between 18 fluoride-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) parameters and histopathological features in patients with early-stage invasive ductal breast carcinoma (IDBC). Methods: Patients with early-stage IDBC who underwent 18 F-FDG PET/CT scan for staging were included in this retrospective study. The status of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2, Ki-67 proliferative index, and grades of tumors were recorded. The conventional metabolic parameters [maximum standard uptake value (SUV max ) and average standard uptake value] and volume-based parameters [metabolic tumor volume (MTV) and total lesion glycolysis] of the primary tumor were obtained from the 18 F-FDG PET/CT images. The associations and correlations between the 18 F-FDG PET/CT parameters and histopathological features were assessed. Results: One hundred forty-three patients were included. 18 F-FDG PET/CT parameters, other than MTV, were significantly associated with the ER and PR status and Ki-67 index, while T-staging was significantly associated with all 18 F-FDG PET/CT parameters. In the axillary lymph node (ALN) involvement, no significant difference was found in the 18 F-FDG PET/CT parameters. In terms of the pathological stage, a significant difference was found in all 18 F-FDG PET/CT parameters. 18 F-FDG PET/CT parameters, other than MTV, were significantly higher in non-luminal breast tumors than luminal tumors and in high-grade tumors than low-grade ones. Triple-negative tumors had the highest 18 F-FDG PET/CT parameter, but the difference was insignificant for MTV. The SUV max had the strongest correlation with Ki-67 proliferative index. Conclusion: Tumors with aggressive histopathological features had higher 18 F-FDG PET/CT parameter values. This study suggests that 18 F-FDG PET/CT may provide prognostic information in patients with early-stage IDBC.

The Value of 18F-FDG PET/CT Imaging in the Evaluation of Interim Neoadjuvant Chemotherapy Response in Locally Advanced Breast Cancer

“…In our study, it was shown that baseline SUV max was higher in HER2 positive and triple-negative cases compared to luminal groups, which supports the published research ( Figure 2 ). Also, studies showing a significant relation between SUV max and the ki-67 levels or lymphatic and vascular invasion are available in the literature ( 11 , 12 , 13 ). Like studies on this subject, a statistically significant correlation was found between the ki-67 index and baseline SUV max -T, SUV max -N, ΔSUV max -T, and ΔSUV max -N.…”