Prognostic role of 18F-FDG PET-CT in the prone position in the evaluation of invasive breast carcinoma
DOI:
https://doi.org/10.29289/2594539420210062Palavras-chave:
breast neoplasms, PET/CT, triple negative breast cancer, survivalResumo
Introduction: The objective of this study was to correlate the features of invasive breast carcinoma in 18F-FDG positron emission tomography/computed tomography with histopathological results, findings from other imaging methods, and survival. Methods: This observational single-center study included patients who underwent staging 18F-FDG positron emission tomography/ computed tomography between September 2012 and April 2019; the results were correlated with the findings of other imaging tests and anatomopathological results. Lesions were evaluated for their maximum standardized uptake value on positron emission tomography/computed tomography performed in the prone position. Tumors were classified into three subtypes (luminal, HER2 and triple-negative) based on immunohistochemical analyses. Results: A total of 125 patients with a mean age of 52 years (24–90 years) were analyzed. The primary tumor showed an increased 18F-FDG concentration on positron emission tomography/computed tomography in 122 (97.6%) patients, with a mean maximum standardized uptake value of 7.15 (1.0–32.9 range). The mean maximum standardized uptake value was higher in the triple-negative subtype (11.4; n=24) than in the luminal (6.2; n=89) and HER2 (5.0; n=9) subtypes (p<0.01). Tumors with more aggressive histological and immunohistochemical characteristics showed higher maximum standardized uptake values. Patients with a standardized uptake value greater than 7 in the primary tumor or greater than 6.7 in the axillary lymph nodes had poor overall survival (p=0.03 and p<0.01, respectively). Conclusions: Our study suggests that the maximum standardized uptake value obtained on positron emission tomography/computed tomography in the prone position may correlate with the tumor immunophenotype and overall survival regardless of the treatments performed, and can be used as a prognostic biomarker in invasive breast carcinoma patients.
Downloads
Referências
Brazil. Ministério da Saúde. Instituto Nacional de Câncer José Alencar Gomes da Silva. A situação do câncer de mama no Brasil: síntese de dados dos sistemas de informação [internet]. Rio de Janeiro: INCA; 2019.
Brazil. Ministério da Saúde. Instituto Nacional de Câncer José Alencar Gomes da Silva. Estimate/2018 – Cancer Incidence in Brazil. Rio de Janeiro: INCA; 2017.
Jafari SH, Saadatpour Z, Salmaninejad A, Momeni F, Mokhtari M, Nahand JS, et al. Breast cancer diagnosis: imaging techniques and biochemical markers. J Cell Physiol. 2018;233(7):5200-13. https://doi.org/10.1002/jcp.26379
Surov A, Meyer HJ, Wienke A. Associations between PET parameters and expression of Ki-67 in breast cancer. Transl Oncol. 2019;12(2):375-80. https://doi.org/10.1016/j.tranon.2018.11.005
Bitencourt AGV, Lima ENP, Chojniak R, Marques EF, Souza JA, Graziano L, et al. Correlation between PET/CT results and histological and immunohistochemical findings in breast carcinomas. Radiol Bras. 2014;47(2):67-73. https://doi.org/10.1590/S0100-39842014000200006
Yutani K, Tatsumi M, Uehara T, Nishimura T. Effect of patients’ being prone during FDG PET for the diagnosis of breast cancer. AJR Am J Roentgenol. 1999;173(5):1337-9. https://doi.org/10.2214/ajr.173.5.105411147.
Magometschnigg HF, Baltzer PA, Fueger B, Helbich TH, Karanikas G, Dubsky P, et al. Diagnostic accuracy of (18)F-FDG PET/CT compared with that of contrast-enhanced MRI of the breast at 3 T. Eur J Nucl Med Mol Imaging. 2015;42(11):1656-65. https://doi.org/10.1007/s00259-015-3099-1
Teixeira SC, Koolen BB, Vogel WV, Wesseling J, Stokkel MPM, Vrancken Peeters MJTFD, et al. Additional prone 18F-FDG PET/CT acquisition to improve the visualization of the primary tumor and regional lymph node metastases in stage II/III breast cancer. Clin Nucl Med. 2016;41(4):e181-6. https://doi.org/10.1097/RLU.0000000000001101
Melsaether A, Moy L. Breast PET/MR Imaging. Radiol Clin North Am. 2017;55(3):579-89. https://doi.org/10.1016/j.rcl.2016.12.011
Allison KH, Hammond MEH, Dowsett M, McKernin SE, Carey LA, Fitzgibbons PL, et al. Estrogen and progesterone receptor testing in breast cancer: ASCO/CAP guideline update. J Clin Oncol. 2020;38(12):1346-66. https://doi.org/10.1200/JCO.19.02309
Wolff AC, Hammond MEH, Allison KH, Harvey BE, Mangu PB, Bartlett JMS, et al. Human epidermal growth factor receptor 2 testing in breast cancer: American society of clinical oncology/college of American pathologists clinical practice guideline focused update. J Clin Oncol. 2018;36(20):2105-22. https://doi.org/10.1200/JCO.2018.77.8738
American College of Radiology. Atlas BI-RADS ® do ACR: sistema de laudos e registro de dados de imagem da mama Colégio Bras. Radiol e Diagnóstico por Imagem [internet]. 2016 [cited on Jan. 20, 2020]. Available at: https://www.acr.org/-/media/ACR/Files/RADS/BI-RADS/MRI-Reporting.pdf
Chae EY, Cha JH, Kim HH, Shin HJ, Kim HJ, Oh HY, et al. Analysis of incidental focal hypermetabolic uptake in the breast as detected by 18F-FDG PET/CT: clinical significance and differential diagnosis. Acta Radiol. 2012;53(5):530-5. https://doi.org/10.1258/ar.2012.120015
Orsaria P, Chiaravalloti A, Caredda E, Marchese PV, Titka B, Anemona L, et al. Evaluation of the usefulness of FDG-PET/CT for nodal staging of breast cancer. Anticancer Res. 2018;38(12):6639-52. https://doi.org/10.21873/anticanres.13031
Basu S, Chen W, Tchou J, Mavi A, Cermik T, Czerniecki B, et al. Comparison of triple-negative and estrogen receptor-positive/progesterone receptor-positive/HER2-negative breast carcinoma using quantitative fluorine-18 fluorodeoxyglucose/positron emission tomography imaging parameters. Cancer. 2008;112(5):995-1000. https://doi.org/10.1002/cncr.23226
Ueda S, Tsuda H, Asakawa H, Shigekawa T, Fukatsu K, Kondo N, et al. Clinicopathological and prognostic relevance of uptake level using 18F-fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging (18F-FDG PET/CT) in primary breast cancer. Jpn J Clin Oncol. 2008;38(4):250-8. https://doi.org/10.1093/jjco/hyn019
Avril N, Rosé CA, Schelling M, Dose J, Kuhn W, Bense S, et al. Breast imaging with positron emission tomography and fluorine-18 fluorodeoxyglucose: use and limitations. J Clin Oncol. 2000;18(20):3495-502. https://doi.org/10.1200/JCO.2000.18.20.3495
Moy L, Noz ME, Maguire GQ, Ponzo F, Deans AE, Murphy-Walcott AD, et al. Prone mammoPET acquisition improves the ability to fuse MRI and PET breast scans. Clin Nucl Med. 2007;32(3):194-8. https://doi.org/10.1097/01.rlu.0000255055.10177.80
Pinker K, Bogner W, Baltzer P, Karanikas G, Magometschnigg H, Brader P, et al. Improved differentiation of benign and malignant breast tumors with multiparametric 18Fluorodeoxyglucose positron emission tomography magnetic resonance imaging: a feasibility study. Clin Cancer Res. 2014;20(13):3540-9. https://doi.org/10.1158/1078-0432.CCR-13-2810
Jo JE, Kim JY, Lee SH, Kim S, Kang T. Preoperative 18F-FDG PET/CT predicts disease-free survival in patients with primary invasive ductal breast cancer. Acta Radiol. 2015;56(12):1463-70. https://doi.org/10.1177/0284185114556929
Bispo ACDA, Nascimento LTC, Costa FM, Silva JB, Mamede M. Development of an HPLC method for the radiochemical purity evaluation of [18F]fluoroestradiol. Braz J Radiat Sci. 2019;7(2A):1-9. https://doi.org/10.15392/bjrs.v7i2A.746
Kumar M, Salem K, Michel C, Jeffery JJ, Yan Y, Fowler AM. 18F-fluoroestradiol PET imaging of activating estrogen receptor-α mutations in breast cancer. J Nucl Med. 2019;60(9):1247-52. https://doi.org/10.2967/jnumed.118.224667
Sundararajan L, Linden HM, Link JM, Krohn KA, Mankoff DA. 18F-Fluoroestradiol. Semin Nucl Med. 2007;37(6):470-6. https://doi.org/10.1053/j.semnuclmed.2007.08.003
Miladinova D. Molecular imaging in breast cancer. Nucl Med Mol Imaging. 2019;53(5):313-9. https://doi.org/10.1007/s13139-019-00614-w
Downloads
Publicado
Como Citar
Edição
Seção
Licença

Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.






