Elahmadawy Mai Amr, Abdelhamed Heba, Gamal El-Din Dina Hosny, Eltohamy Mahitab, Ismail Hassan Adel Mohamed, Abd El-Gaid Salwa
Nuclear Medicine Unit, National Cancer Institute (NCI), Cairo University, Cairo, Egypt.
Clinical oncology and nuclear medicine department, Zagazig University, Zagazig Egypt.
Asia Ocean J Nucl Med Biol. 2025;13(1):10-20. doi: 10.22038/aojnmb.2024.79970.1563.
to investigate the capability of F-fluorodeoxyglucose positron emission tomography/computed tomography ([F]-FDG PET/CT) derived volumetric parameters to predict human epidermal growth factor receptor 2 (HER2) status in breast cancer patients.
retrospective study enrolled 47 female patients with breast cancer. All patients had pretreatment [F]-FDG PET/CT. Clinical data, pathology report and HER2 status were retrieved from medical records. In an attempt to assess the predictive value of the PET-derived metabolic parameters, Receiver operating characteristic (ROC) curve was constructed with area under curve analysis performed to detect best cutoff value of significant parameters for detection of HER2 positive.
No statistically significant difference was noted among both groups (HER2 positive and negative) in respect to age, menopausal status, histology, grade, T-stage, N-stage, or antigen Kiel 67 (Ki-67) index. ROC curve successfully marked cutoff point ≥42.35 for total lesion glycolysis (TLG) and 12.75 for metabolic tumor value (MTV) that are capable to discriminate positive versus negative HER2 expression in breast cancer patients with area under curve (AUC) 0.728 and 0.723 and P-values 0.002 and 0.004 respectively. Such cutoff point was not deduced for standard uptake value (SUV) max. Primary tumor TLG cutoff correlated well with age where 77.8% of patients with TLG 42.35 were older than 45 years old compared to 22.2% of them who were younger than 45 years, P-value0.047. Also 70.3% of patients with TLG exceeds 42.35 had T3 and 4 primary tumors while 65% of those with TLG <42.35 their primary tumors were T1 and 2, P-value0.03. As regards Primary tumor MTV cutoff point, significant correlations were noted in respect to T-stage where 78.2% of the patients with primary tumor MTV 12.75 were T3 and 4, compared to 66.6% of those with primary tumor MTV <12.75 were T1 and 2, P-value0.011.
PET-derived volumetrics may serve as non-invasive predictors of biological processes represented here as HER2 expression in breast cancer patients.
研究氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（[F]-FDG PET/CT）得出的体积参数预测乳腺癌患者人表皮生长因子受体2（HER2）状态的能力。
回顾性研究纳入47例女性乳腺癌患者。所有患者均在治疗前进行了[F]-FDG PET/CT检查。从病历中获取临床数据、病理报告和HER2状态。为了评估PET衍生代谢参数的预测价值，构建了受试者操作特征（ROC）曲线，并进行曲线下面积分析以检测HER2阳性检测的显著参数的最佳截断值。
两组（HER2阳性和阴性）在年龄、绝经状态、组织学、分级、T分期、N分期或抗原Kiel 67（Ki-67）指数方面均未观察到统计学上的显著差异。ROC曲线成功标记出总病变糖酵解（TLG）的截断点≥42.35，代谢肿瘤体积（MTV）的截断点为12.75，这两个参数能够区分乳腺癌患者HER2表达的阳性与阴性，曲线下面积（AUC）分别为0.728和0.723，P值分别为0.002和0.004。对于最大标准摄取值（SUV）max未得出这样的截断点。原发肿瘤TLG截断点与年龄密切相关，TLG≥42.35的患者中77.8%年龄大于45岁，而年龄小于45岁的患者占22.2%，P值为0.047。此外，TLG超过42.35的患者中70.3%的原发肿瘤为T3和4期，而TLG<42.35的患者中65%的原发肿瘤为T1和2期，P值为0.03。关于原发肿瘤MTV截断点，在T分期方面观察到显著相关性，原发肿瘤MTV≥12.75的患者中78.2%为T3和4期，而原发肿瘤MTV<12.75的患者中66.6%为T1和2期，P值为0.011。
PET衍生的体积参数可作为乳腺癌患者中以HER2表达为代表的生物过程的非侵入性预测指标。
