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Association of primary tumour FDG uptake with clinical, histopathological and molecular characteristics in breast cancer patients scheduled for neoadjuvant chemotherapy

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to evaluate the association of primary tumour 18F-fluorodeoxyglucose (FDG) uptake with clinical, histopathological and molecular characteristics of breast cancer patients scheduled for neoadjuvant chemotherapy. Second, we wished to establish for which patients pretreatment positron emission tomography (PET)/CT could safely be omitted because of low FDG uptake.

Methods

PET/CT was performed in 214 primary stage II or III breast cancer patients in the prone position with hanging breasts. Tumour FDG uptake was qualitatively evaluated to determine the possibility of response monitoring with PET/CT and was quantitatively assessed using maximum standardized uptake values (SUVmax). FDG uptake was compared with age, TNM stage, histology, hormone and human epidermal growth factor receptor 2 status, grade, Ki-67 and molecular subtype in univariable and multivariable analyses.

Results

In 203 tumours (95 %) FDG uptake was considered sufficient for response monitoring. No subgroup of patients with consistently low tumour FDG uptake could be identified. In a univariable analysis, SUVmax was significantly higher in patients with distant metastases at staging examination, non-lobular carcinomas, tumours with negative hormone receptors, triple negative tumours, grade 3 tumours, and in tumours with a high proliferation index (Ki-67 expression). After multiple linear regression analysis, triple negative and grade 3 tumours were significantly associated with a higher SUVmax.

Conclusion

Primary tumour FDG uptake in breast cancer patients scheduled for neoadjuvant chemotherapy is significantly higher in tumours with prognostically unfavourable characteristics. Based on tumour characteristics associated with low tumour FDG uptake, this study was unable to identify a subgroup of patients unlikely to benefit from pretreatment PET/CT.

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Acknowledgements

This study was performed within the framework of CTMM, the Center for Translational and Molecular Medicine (www.ctmm.nl), project Breast CARE (grant 03O-104).

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    B. B. Koolen, W. V. Vogel, T. S. Aukema & R. A. Valdés Olmos

  2. Department of Surgical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    B. B. Koolen, M. J. T. F. D. Vrancken Peeters, T. S. Aukema & E. J. Th. Rutgers

  3. Department of Pathology and Experimental Therapy, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    J. Wesseling & E. H. Lips

  4. Department of Biometrics, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    E. van Werkhoven

  5. Department of Radiology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    K. G. A. Gilhuijs

  6. Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    S. Rodenhuis

  7. Department of Radiology, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands

    K. G. A. Gilhuijs

Authors
  1. B. B. Koolen
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  2. M. J. T. F. D. Vrancken Peeters
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  4. E. H. Lips
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  5. W. V. Vogel
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  6. T. S. Aukema
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  7. E. van Werkhoven
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  8. K. G. A. Gilhuijs
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  10. E. J. Th. Rutgers
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  11. R. A. Valdés Olmos
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Corresponding author

Correspondence to R. A. Valdés Olmos.

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Koolen, B.B., Vrancken Peeters, M.J.T.F.D., Wesseling, J. et al. Association of primary tumour FDG uptake with clinical, histopathological and molecular characteristics in breast cancer patients scheduled for neoadjuvant chemotherapy. Eur J Nucl Med Mol Imaging 39, 1830–1838 (2012). https://doi.org/10.1007/s00259-012-2211-z

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  • DOI: https://doi.org/10.1007/s00259-012-2211-z

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