Exploring Tumor Biology with Fluorodeoxyglucose-Positron Emission Tomography Imaging in Breast Carcinoma

This article reviews the promising application of fluorodeoxyglucose-positron emission tomography (FDG-PET) imaging in exploring tumor biology of breast carcinoma based upon the authors' experience and also reviews current literature on this topic. The interest in this novel aspect of breast PET imaging has gained momentum in recent years as more is understood about the molecular subtypes and heterogeneous behavior of breast cancer. With the development of newer targeted therapies, oncologists are realizing the need for a means of accurate prediction and assessment of treatment response early in the course of therapy. Hence the studies on FDG-PET imaging in exploring the tumor biology of breast carcinoma have focused on: tumor histologic subtypes, hormonal receptor expression, disease burden at diagnosis, tumor proliferation index, and other molecular parameters. The correlation of various PET tracer parameters (eg, 15O-water PET-derived blood flow measurements and 18F-FDG-PET derived glucose metabolism rate parameters) is also of considerable interest. To summarize, the utility of FDG-PET/CT imaging on this aspect of breast carcinoma imaging holds considerable promise in disease characterization, and it can be foreseen that it will soon aid in guiding and adapting newer therapeutic regimens.