Ege Aktas Gul, Taştekin Ebru, Sarikaya Ali
Departments of Nuclear Medicine.
Pathology, Trakya University Medical Faculty Hospital, Edirne, Turkey.
Nucl Med Commun. 2018 Jan;39(1):83-93. doi: 10.1097/MNM.0000000000000779.
The aim of this study was to evaluate the relationship of baseline fluorine-18-fluorodeoxyglucose PET/computed tomography (CT)-derived volumetric parameters for the primary tumor with clinicopathological risk factors and molecular subtypes in patients with invasive ductal breast carcinoma (IDBC).
We evaluated 65 patients who underwent fluorine-18-fluorodeoxyglucose PET/CT for initial breast cancer staging. The association of maximum and mean standardized uptake values (SUVmax and SUVmean, respectively), metabolic tumor volume, and total lesion glycolysis (TLG) with clinicopathological risk factors and molecular subtypes was investigated and the discriminative power of significant features was assessed.
All volumetric parameters were significantly higher for tumors measuring more than 2 cm and with a Ki-67 index of at least 20. Estrogen receptor (ER) and progesterone receptor (PR)-negative (ER-/PR-), human epidermal growth factor receptor 2-positive (HER2+), and triple-negative tumors showed increased SUVmax. SUVmax and SUVmean were higher for triple-negative and HER2+ IDBC than for ER+/HER2- IDBC. Metabolic tumor volume and TLG showed no differences among subtypes. All volumetric parameters correlated with the clinical tumor size and the Ki-67 index; these correlations differed among the different subtypes. Patients with systemic metastases showed significantly higher TLG. Receiver operating characteristic analysis showed that SUVmax had the highest discriminative power for the different subtypes, whereas TLG had a statistically significant discriminative power for systemic metastasis.
SUVmax may appropriately reflect the immunohistochemical characteristics of IDBC, whereas TLG is associated with clinical risk factors and systemic metastasis. Our preliminary findings suggesting different relationships between volumetric parameters and the clinical tumor size and the Ki-67 index for different subtypes require further evaluation.
本研究旨在评估浸润性导管癌（IDBC）患者原发性肿瘤的基线氟-18-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（PET/CT）衍生的体积参数与临床病理危险因素及分子亚型之间的关系。
我们评估了65例行氟-18-氟脱氧葡萄糖PET/CT进行初始乳腺癌分期的患者。研究了最大和平均标准化摄取值（分别为SUVmax和SUVmean）、代谢肿瘤体积和总病变糖酵解（TLG）与临床病理危险因素及分子亚型的关联，并评估了显著特征的鉴别能力。
对于直径大于2 cm且Ki-67指数至少为20的肿瘤，所有体积参数均显著更高。雌激素受体（ER）和孕激素受体（PR）阴性（ER-/PR-）、人表皮生长因子受体2阳性（HER2+）以及三阴性肿瘤的SUVmax升高。三阴性和HER2+ IDBC的SUVmax和SUVmean高于ER+/HER2- IDBC。代谢肿瘤体积和TLG在各亚型之间无差异。所有体积参数均与临床肿瘤大小和Ki-67指数相关；这些相关性在不同亚型之间有所不同。发生全身转移的患者TLG显著更高。受试者工作特征分析表明，SUVmax对不同亚型具有最高的鉴别能力，而TLG对全身转移具有统计学显著的鉴别能力。
SUVmax可能适当地反映IDBC的免疫组化特征，而TLG与临床危险因素及全身转移相关。我们的初步研究结果表明，不同亚型的体积参数与临床肿瘤大小和Ki-67指数之间存在不同关系，这需要进一步评估。
