18F-FDG PET/CT imaging versus dynamic contrast-enhanced CT for staging and prognosis of inflammatory breast cancer

  • Laurence Champion
  • Florence Lerebours
  • Pascal Cherel
  • Veronique Edeline
  • Anne-Laure Giraudet
  • Myriam Wartski
  • Dominique Bellet
  • Jean-Louis Alberini
Original Article

DOI: 10.1007/s00259-013-2405-z

Cite this article as:
Champion, L., Lerebours, F., Cherel, P. et al. Eur J Nucl Med Mol Imaging (2013) 40: 1206. doi:10.1007/s00259-013-2405-z

Abstract

Purpose

Inflammatory breast cancer (IBC) is the most aggressive type of breast cancer with a poor prognosis. Locoregional staging is based on dynamic contrast-enhanced (DCE) CT or MRI. The aim of this study was to compare the performances of FDG PET/CT and DCE CT in locoregional staging of IBC and to assess their respective prognostic values.

Methods

The study group comprised 50 women (median age: 51 ± 11 years) followed in our institution for IBC who underwent FDG PET/CT and DCE CT scans (median interval 5 ± 9 days). CT enhancement parameters were net maximal enhancement, net early enhancement and perfusion.

Results

The PET/CT scans showed intense FDG uptake in all primary tumours. Concordance rate between PET/CT and DCE CT for breast tumour localization was 92 %. No significant correlation was found between SUVmax and CT enhancement parameters in primary tumours (p > 0.6). PET/CT and DCE CT results were poorly correlated for skin infiltration (kappa = 0.19). Ipsilateral foci of increased axillary FDG uptake were found in 47 patients (median SUV: 7.9 ± 5.4), whereas enlarged axillary lymph nodes were observed on DCE CT in 43 patients. Results for axillary node involvement were fairly well correlated (kappa = 0.55). Nineteen patients (38 %) were found to be metastatic on PET/CT scan with a significant shorter progression-free survival than patients without distant lesions (p = 0.01). In the primary tumour, no statistically significant difference was observed between high and moderate tumour FDG uptake on survival, using an SUVmax cut-off of 5 (p = 0.7 and 0.9), or between high and low tumour enhancement on DCE CT (p > 0.8).

Conclusion

FDG PET/CT imaging provided additional information concerning locoregional involvement to that provided by DCE CT on and allowed detection of distant metastases in the same whole-body procedure. Tumour FDG uptake or CT enhancement parameters were not correlated and were not found to have any prognostic value.

Keywords

FDG PET/CTDynamic contrast-enhanced CTInflammatory breast cancerStagingPrognosis

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Laurence Champion
    • 1
  • Florence Lerebours
    • 2
  • Pascal Cherel
    • 3
  • Veronique Edeline
    • 1
  • Anne-Laure Giraudet
    • 1
  • Myriam Wartski
    • 1
  • Dominique Bellet
    • 1
    • 4
  • Jean-Louis Alberini
    • 1
    • 5
  1. 1.Service de Médecine nucléaireSaint-CloudFrance
  2. 2.Service d’oncologie médicaleSaint-CloudFrance
  3. 3.Service de RadiologieInstitut Curie, Hôpital René HugueninSaint-CloudFrance
  4. 4.Pharmacologie Chimique et Génétique & Imagerie, Inserm U1022 CNRS UMR 8151, Faculté des sciences pharmaceutiques et biologiquesUniversité Paris DescartesParisFrance
  5. 5.Faculté de médecineUniversité Versailles Saint-QuentinSaint-Quentin-en-YvelinesFrance