Do clinical, histological or immunohistochemical primary tumour characteristics translate into different 18F-FDG PET/CT volumetric and heterogeneity features in stage II/III breast cancer?

  • David Groheux
  • Mohamed Majdoub
  • Florent Tixier
  • Catherine Cheze Le Rest
  • Antoine Martineau
  • Pascal Merlet
  • Marc Espié
  • Anne de Roquancourt
  • Elif Hindié
  • Mathieu Hatt
  • Dimitris Visvikis
Original Article

Abstract

Purpose

The aim of this retrospective study was to determine if some features of baseline 18F-FDG PET images, including volume and heterogeneity, reflect clinical, histological or immunohistochemical characteristics in patients with stage II or III breast cancer (BC).

Methods

Included in the present retrospective analysis were 171 prospectively recruited patients with stage II/III BC treated consecutively at Saint-Louis hospital. Primary tumour volumes were semiautomatically delineated on pretreatment 18F-FDG PET images. The parameters extracted included SUVmax, SUVmean, metabolically active tumour volume (MATV), total lesion glycolysis (TLG) and heterogeneity quantified using the area under the curve of the cumulative histogram and textural features. Associations between clinical/histopathological characteristics and 18F-FDG PET features were assessed using one-way analysis of variance. Areas under the ROC curves (AUC) were used to quantify the discriminative power of the features significantly associated with clinical/histopathological characteristics.

Results

T3 tumours (>5 cm) exhibited higher textural heterogeneity in 18F-FDG uptake than T2 tumours (AUC <0.75), whereas there were no significant differences in SUVmax and SUVmean. Invasive ductal carcinoma showed higher SUVmax values than invasive lobular carcinoma (p = 0.008) but MATV, TLG and textural features were not discriminative. Grade 3 tumours had higher FDG uptake (AUC 0.779 for SUVmax and 0.694 for TLG), and exhibited slightly higher regional heterogeneity (AUC 0.624). Hormone receptor-negative tumours had higher SUV values than oestrogen receptor-positive (ER-positive) and progesterone receptor-positive tumours, while heterogeneity patterns showed only low-level variation according to hormone receptor expression. HER-2 status was not associated with any of the image features. Finally, SUVmax, SUVmean and TLG significantly differed among the three phenotype subgroups (HER2-positive, triple-negative and ER-positive/HER2-negative BCs), but MATV and heterogeneity metrics were not discriminative.

Conclusion

SUV parameters, MATV and textural features showed limited correlations with clinical and histopathological features. The three main BC subgroups differed in terms of SUVs and TLG but not in terms of MATV and heterogeneity. None of the PET-derived metrics offered high discriminative power.

Keywords

18F-FDG PET/CT Heterogeneity Textural features Breast cancer 

Supplementary material

259_2015_3110_MOESM1_ESM.doc (60 kb)
Supplemental Table 1(DOC 60 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • David Groheux
    • 1
  • Mohamed Majdoub
    • 2
  • Florent Tixier
    • 3
  • Catherine Cheze Le Rest
    • 3
  • Antoine Martineau
    • 1
  • Pascal Merlet
    • 1
  • Marc Espié
    • 4
  • Anne de Roquancourt
    • 5
  • Elif Hindié
    • 6
  • Mathieu Hatt
    • 2
  • Dimitris Visvikis
    • 2
  1. 1.Department of Nuclear MedicineSaint-Louis HospitalParisFrance
  2. 2.INSERM, UMR 1101 LaTIMBrestFrance
  3. 3.DACTIM, Department of Nuclear MedicineMilétrie HospitalPoitiersFrance
  4. 4.Breast Diseases Unit and Department of Medical OncologySaint-Louis HospitalParisFrance
  5. 5.Department of PathologySaint-Louis HospitalParisFrance
  6. 6.Department of Nuclear Medicine, CHU BordeauxUniversity of BordeauxBordeauxFrance

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