Semi-quantitative lymph node assessment of 18F-FDG PET/CT in locally advanced breast cancer: correlation with biological prognostic factors

• Published in: European journal of nuclear medicine and molecular imaging 2013, Vol.40 (1), p.72-79
• Main Authors: García Vicente, Ana María, Soriano Castrejón, Ángel, Cruz Mora, Miguel Ángel, González Ageitos, Ana, Muñoz Sánchez, María del Mar, León Martín, Alberto, Espinosa Aunión, Ruth, Relea Calatayud, Fernanda, Muñoz Madero, Vicente, Chacón López-Muñiz, Ignacio, Cordero García, Jose Manuel, Jiménez Londoño, Germán Andrés
• Format: Article
• Language: English
• Subjects: Cardiology; Imaging; Medicine; Medicine & Public Health; Nuclear Medicine; Oncology; Original Article; Orthopedics; Radiology
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-012-2244-3

Purpose The aim of this study was to analyse the correlation between dual-time-point 18 F-2-deoxy-2-fluoro- D -glucose (FDG) uptakes in lymph nodes assessed by positron emission tomography (PET)/CT and histopathological and immunohistochemical prognostic factors. Methods Seventy-five women with locally advanced breast cancer were prospectively evaluated. PET/CT was requested in the initial staging previous to adjuvant chemotherapy (multicentre study). All of the patients underwent 18 F-FDG PET/CT with a dual-time-point acquisition. Both examinations were evaluated qualitatively and semi-quantitatively with calculation of maximum standardized uptake values (SUV max ) in PET-1 (SUV-1) and in PET-2 (SUV-2) and the percentage variation of the SUV or retention index (RI) between PET-1 and PET-2 in lymph nodes with the greater 18 F-FDG uptake. The biological prognostic parameters such as the steroid receptor status, p53 and HER2 expression, proliferation rate (Ki-67) and grading were determined from tissue of the primary tumour. Metabolic and biological parameters were correlated using Spearman’s rank-order correlation coefficient and Mann-Whitney U and Kruskal–Wallis tests. Results Negative receptor status was correlated with higher SUV-1, SUV-2 and RI in lymph nodes. The results were significant for progesterone receptor status. p53 over-expression and triple-negative status were associated with greater semi-quantitative parameters in lymph nodes. Higher tumoural grades were related with greater semi-quantitative parameters ( p  > 0.05). Conclusion Biological factors of bad prognosis were correlated with higher semi-quantitative metabolic values in lymph nodes. Therefore these results appear to reveal biological significance of lymph node 18 F-FDG accumulation.