The usefulness of fluorodeoxyglucose-PET/CT for preoperative evaluation of ductal carcinoma <i>in situ</i>

Kim, Sung‐Chul; Lee, Seokjae; Kim, Sangwon; Lee, Seokmo; Yum, Ha-Yong

doi:10.4174/astr.2018.94.2.63

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…Because of the low FDG uptake of DCIS, the semi-quantitative analysis has limited reliability; therefore, a more sensitive visual analysis was performed simultaneously. Some recent studies of DCIS upgrade, assessed by PET/CT scan, have conducted a visual analysis along with SUV max measurement (22,23). In this study, the SUV max and visual analysis were predictors of DCIS upgrade to invasive cancer in both univariate and multivariate models, similar to previous studies (2,4).…”

Section: Discussionsupporting

confidence: 80%

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Role of FDG-PET/CT in Identification of Histological Upgrade of Ductal Carcinoma in Situ (DCIS) in Needle Biopsy

et al. 2021

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Background: Accurate preoperative detection of the invasive components of ductal carcinoma in situ (DCIS) is essential for an appropriate treatment. 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scan, which can indicate the metabolic activity and aggressiveness of breast cancer, may be used as one of the predictors of the invasive components of DCIS in needle biopsy. Objectives: To determine whether the FDG-PET/CT findings are associated with the histological upgrade of DCIS in biopsy. Methods: In this retrospective cohort, we reviewed 165 cases of DCIS in 162 patients, who underwent preoperative FDG-PET/CT examinations between April 2008 and September 2015. The clinicopathological characteristics and FDG-PET/CT findings of the patients were compared with respect to cancer invasion. The predictors of DCIS upgrade to invasive cancer were also examined. Moreover, the diagnostic performance of visual and semi-quantitative analyses of FDG-PET/CT in predicting invasion was compared, based on the maximum standardized uptake value (SUVmax), divided by the cutoff point in a receiver operating characteristic (ROC) curve analysis. Results: The final pathological findings indicated 119 cases of pure DCIS and 46 cases of DCIS with invasion. The optimal SUVmax threshold was 1.9 in the ROC curve analysis. Young age, high SUVmax, positivity in the visual analysis of FDG-PET/CT, and large pathological tumor size were significantly more frequent in the DCIS + invasion group. The significant predictors of DCIS histological upgrade were age (P = 0.011), SUVmax (P < 0.001), visual analysis of FDG-PET/CT (P = 0.004), and pathological tumor size (P = 0.003) in the univariate analysis. In the multivariate analysis, the SUVmax (odds ratio [OR] = 3.31, P = 0.003) and tumor size (OR = 1.20, P = 0.022) were significant when the model included the SUVmax, age, and size (model 1). On the other hand, age (OR = 0.96, P = 0.032), visual analysis (OR = 4.67, P = 0.006), and tumor size (OR = 1.25, P = 0.005) were significant predictors when the model included visual analysis, age, and size (model 2). The sensitivity was significantly higher in the visual analysis, whereas the specificity, positive predictive value (PPV), and accuracy were significantly higher in the semi-quantitative analysis. Conclusion: FDG-PET/CT is a potentially useful imaging tool to predict the upgrade of DCIS to invasive cancer.

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Section: Discussionsupporting

confidence: 80%

“…Generally, there are contradictory results regarding the role of tumor grade. The tumor grade in biopsy (5,12) and the final pathology (2,7,11,12) was recognized as a significant independent predictor in some previous studies, but not in some others (9,13,23).…”

Section: Discussionmentioning

confidence: 85%