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

• Published in: European journal of nuclear medicine and molecular imaging Vol. 40; no. 1; pp. 72 - 79
• Main Authors: Garcia Vicente, Ana Maria, Soriano Castrejon, Angel, Cruz Mora, Miguel Angel, Gonzalez Ageitos, Ana, Munoz Sanchez, Maria del Mar, Leon Martin, Alberto, Espinosa Aunion, Ruth, Relea Calatayud, Fernanda, Munoz Madero, Vicente, Chacon Lopez-Muniz, Ignacio, Cordero Garcia, Jose Manuel, Jimenez Londono, German Andres
• Format: Journal Article
• Language: English
• Published: 01.01.2013
• Subjects: Adjuvants; Breast cancer; Chemotherapy; Computed tomography; ErbB-2 protein; Lymph nodes; Nuclear medicine; Overexpression; p53 protein; Positron emission tomography; Progesterone receptors; Prognosis; Steroid hormone receptors
• 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 super(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 super(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 sub(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 super(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 super(18)F-FDG accumulation.