Correlation of primary tumor metabolic parameters with clinical, histopathological and molecular characteristics in breast cancer patients at pre-operative staging FDG-PET/CT study

• Published in: Egyptian journal of radiology and nuclear medicine 2021-07, Vol.52 (1), p.171-11
• Main Authors: AbdElaal, Asmaa A, Zaher, Ahmed M, Abdelgawad, Marwa I, Mekkawy, Mohamed A, Eloteify, Lamiaa M
• Format: Article
• Language: English
• Subjects: Breast cancer; Cancer; Cancer patients; Cancer therapies; Care and treatment; Chemotherapy; Computer industry; CT imaging; Epidermal growth factor; Estrogen; FDG PET/CT; Females; Glucose; Health aspects; Histopathology; Initial staging; Liver; Lymphatic system; Mammography; Medical imaging; Menopause; Metabolism; Metastasis; Oncology, Experimental; Patients; PET imaging; Progesterone; Sport-utility vehicles; SUVmax; TLR; Tomography; Tumors; Women; Work stations
• ISSN: 0378-603X; 2090-4762
• DOI: 10.1186/s43055-021-00548-4

Background The aim of this prospective study was to evaluate the correlation of primary tumor metabolic activity parameters; maximum standardized uptake value (SUVmax) and tumor SUVmax/liver average SUV ratio (TLR) with clinical, histopathological and molecular characteristics of initial staging breast cancer (BC) patients using 18F-fluorodeoxyglucose (FDG) positron emission tomography / computerized tomography (PET/CT) scan. Results Forty female patients with newly diagnosed BC were enrolled in our study, age ranging from 31-78 years (mean 50.5 +/- SD11.7). All the primary tumors were detected with mean SUVmax 10.8(+/-SD 7.9). The mean /median SUVmax values of primary tumor was higher in premenopausal, stage III and IV, Estrogen Receptors negative( ER-), Progesterone Receptors negative(PR-), Human epidermal growth factor receptor 2 positive ( Her2neu+) patients, high nuclear grade (GIII), triple negative molecular subgroup (TN) and positive axillary lymph node (ALNs) metastasis,(P= 0.003, 0.017, 0.113, 0.089 0.01,0.002, 0.007 and 0.016 respectively). The mean/median TLR values was higher in premenopausal,Her2neu+, GIII, TN molecular subtype patients, stage III and IV and in patients with positive ALNs, ER- and PR - patients (P= 0.002, 0.0476, 0.005, 0.018, 0.039 and 0.022, 0.095 and 0.129 respectively). SUVmax of the primary lesion and TLR were moderately negatively correlated with the age of the patients (P= 0.005 and 0.008 respectively), also they were moderately positively correlated with the size of the primary tumor (P= 0.019 and 0.036 respectively). TLR was predictive of nodal involvement AUC= 0.612 (95% CI: 0.431-792). The overall sensitivity and specificity of PET/CT for axillary staging was 100 % and 60 %, respectively (P= 0.006). Conclusion The SUVmax of the primary tumor and TLR values had similar significant associations with different prognostic factors in BC but only TLR can predict nodal involvement.