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Correlation of breast cancer subtypes, based on estrogen receptor, progesterone receptor, and HER2, with functional imaging parameters from 68Ga-RGD PET/CT and 18F-FDG PET/CT

  • Hai-Jeon Yoon
  • Keon Wook Kang
  • In Kook Chun
  • Nariya Cho
  • Seock-Ah Im
  • Sunjoo Jeong
  • Song Lee
  • Kyeong Cheon Jung
  • Yun-Sang Lee
  • Jae Min Jeong
  • Dong Soo Lee
  • June-Key Chung
  • Woo Kyung Moon
Original Article

Abstract

Purpose

Imaging biomarkers from functional imaging modalities were assessed as potential surrogate markers of disease status. Specifically, in this prospective study, we investigated the relationships between functional imaging parameters and histological prognostic factors and breast cancer subtypes.

Methods

In total, 43 patients with large or locally advanced invasive ductal carcinoma (IDC) were analyzed (47.6 ± 7.5 years old). 68Ga-Labeled arginine-glycine-aspartic acid (RGD) and 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) were performed. The maximum and average standardized uptake values (SUVmax and SUVavg) from RGD PET/CT and SUVmax and SUVavg from FDG PET/CT were the imaging parameters used. For histological prognostic factors, estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression was identified using immunohistochemistry (IHC) or fluorescent in situ hybridization (FISH). Four breast cancer subtypes, based on ER/PR and HER2 expression (ER/PR+,Her2−, ER/PR+,Her2+, ER/PR−,Her2+, and ER/PR−,Her2−), were considered.

Results

Quantitative FDG PET parameters were significantly higher in the ER-negative group (15.88 ± 8.73 vs 10.48 ± 6.01, p = 0.02 for SUVmax; 9.40 ± 5.19 vs 5.92 ± 4.09, p = 0.02 for SUVavg) and the PR-negative group (8.37 ± 4.94 vs 4.79 ± 3.93, p = 0.03 for SUVavg). Quantitative RGD PET parameters were significantly higher in the HER2-positive group (2.42 ± 0.59 vs 2.90 ± 0.75, p = 0.04 for SUVmax; 1.60 ± 0.38 vs 1.95 ± 0.53, p = 0.04 for SUVavg) and showed a significant positive correlation with the HER2/CEP17 ratio (r = 0.38, p = 0.03 for SUVmax and r = 0.46, p < 0.01 for SUVavg). FDG PET parameters showed significantly higher values in the ER/PR−,Her2− subgroup versus the ER/PR+,Her2− or ER/PR+,Her2+ subgroups, while RGD PET parameters showed significantly lower values in the ER/PR−,Her2− subgroup versus the other subgroups. There was no correlation between FDG and RGD PET parameters in the overall group. Only the ER/PR−,Her2− subgroup showed a significant positive correlation between FDG and RGD PET parameters (r = 0.59, p = 0.03 for SUVmax).

Conclusion

68Ga-RGD and 18F-FDG PET/CT are promising functional imaging modalities for predicting biomarkers and molecular phenotypes in breast cancer patients.

Keywords

Arginine-glycine-aspartic acid (RGD) Fluorodeoxyglucose (FDG) Positron emission tomography (PET) Estrogen receptor (ER) Progesterone receptor (PR) Human epidermal growth factor receptor 2 (HER2) 

Notes

Acknowledgement

This study was supported by a grant of the Korea Healthcare Technology R&D Project, Ministry for Health & Welfare, Republic of Korea (A070001 and A100716).

Conflicts of interest

None.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Hai-Jeon Yoon
    • 1
    • 6
    • 11
  • Keon Wook Kang
    • 1
    • 5
    • 6
    • 8
  • In Kook Chun
    • 1
    • 12
  • Nariya Cho
    • 2
  • Seock-Ah Im
    • 3
  • Sunjoo Jeong
    • 10
  • Song Lee
    • 1
    • 6
  • Kyeong Cheon Jung
    • 4
  • Yun-Sang Lee
    • 1
    • 7
  • Jae Min Jeong
    • 1
    • 5
    • 6
    • 8
  • Dong Soo Lee
    • 1
    • 6
    • 9
  • June-Key Chung
    • 1
    • 5
    • 6
    • 8
  • Woo Kyung Moon
    • 2
    • 5
    • 6
  1. 1.Department of Nuclear MedicineSeoul National University College of MedicineSeoulKorea
  2. 2.Department of RadiologySeoul National University College of MedicineJongno-guKorea
  3. 3.Department of Internal MedicineSeoul National University College of MedicineSeoulKorea
  4. 4.Department of PathologySeoul National University College of MedicineSeoulKorea
  5. 5.Department of Biomedical SciencesSeoul National University College of MedicineSeoulKorea
  6. 6.The Institute of Radiation MedicineSeoul National University College of MedicineSeoulKorea
  7. 7.Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and TechnologySeoul National University College of MedicineSeoulKorea
  8. 8.Cancer Research InstituteSeoul National UniversitySeoulKorea
  9. 9.Department of Molecular Medicine and Biopharmaceutical SciencesSeoul National UniversitySeoulKorea
  10. 10.Department of Molecular BiologyDankook UniversityYonginKorea
  11. 11.Department of Nuclear MedicineEwha Womans University School of MedicineSeoulKorea
  12. 12.Department of Nuclear MedicineKangwon National University HospitalChuncheonKorea

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