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Correlation of 18F-fluorodeoxyglucose uptake with histopathological prognostic factors in breast carcinoma
Ozgul Ekmekcioglu1, Anar Aliyev, Sabire Yilmaz
1Departments of aNuclear Medicine bGeneral Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul cDepartment of Nuclear Medicine, Duzce University Medical Faculty, Duzce, Turkey.
Objective:
This study investigated the prognostic value of [18F]-fluorodeoxyglucose (18F-FDG) uptake in breast carcinomas by comparing 18F-FDG PET/computed tomography (CT) images with histopathological and immunohistochemical prognostic factors.
Methods:
This study included 136 women and four men with positive biopsy breast carcinomas who underwent 18F-FDG PET/CT imaging for initial staging. Maximum standardized uptake values (SUVmax) and tumour-to-background SUVmax ratios were calculated and compared with histopathological and immunohistochemical tumour characteristics, patient properties and axillary lymph node involvement. Calculations of SUVmax for men were performed separately.
Results:
For the tumours in women, the mean SUVmax was 10.06±6.91 and the median SUVmax was 9.05 (0.7-35.0). Primary tumour 18F-FDG uptake and tumour-to-background SUVmax ratios were correlated with tumour size (P<0.001), histological type (P<0.001), histological grade (P=0.004), pleomorphism (P=0.010), mitosis count (P<0.001), lymphatic invasion (P=0.009), necrosis (P=0.005), oestrogen negativity (P=0.004), high Ki-67 level (P<0.001), axillary lymph node involvement (P<0.001) and triple negativity (P=0.002). High Ki-67 level (odds ratio=16; 95% confidence interval=1.6-160; P=0.016) and tumour size (odds ratio=4; 95% confidence interval=1.5-11; P=0.007) were determining factors for high 18F-FDG uptake values. Other clinicopathological and immunohistopathological parameters including progesterone receptor (P=0.211), CerbB2 overexpression (P=0.170), perineural invasion (P=0.053), intratumoural calcification (P=0.438), desmoplasia (P=0.112), tubular formation (P=0.768) and age (P=0.675) were not significantly correlated with 18F-FDG uptake. No significant relationship was observed between the tumour/contralateral breast SUVmax ratio and mitotic count, oestrogen receptor status or triple negativity.
Conclusion:
F-FDG uptake may serve as a prognostic indicator for biological behaviour in breast tumours.
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