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Intratumoral heterogeneity on dedicated breast positron emission tomography predicts malignancy grade of breast cancer

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Abstract

Purpose

Dedicated breast positron emission tomography (DbPET) provides detailed high-resolution images and can detect intratumoral heterogeneity using 18F-fluorodeoxyglucose (FDG). We aimed to evaluate the correlation between FDG uptake on DbPET and the clinicopathological features of breast cancer, particularly those with an intratumoral heterogeneous distribution of FDG on DbPET.

Methods

We evaluated 195 consecutive patients with invasive breast cancer who underwent preoperative whole-body PET (WBPET) and DbPET concurrently between January 2016 and March 2017. The relationships between clinicopathological factors and the maximum standard uptake values (SUVmax) of DbPET and WBPET, including clinical stage, nuclear grade, Ki67 proliferation index, estrogen receptor (ER) and human epidermal growth factor receptor type 2 (HER2) statuses, and the intratumoral heterogeneous distribution of FDG on DbPET, were evaluated.

Results

The SUVmax of DbPET was significantly correlated with clinical T stage, N stage, nuclear grade, and Ki67 proliferation index (all p < 0.001) as well as the ER (p = 0.006) and HER2 (p = 0.040) statuses. Intratumoral heterogeneous distribution of FDG on DbPET was significantly related with high nuclear grade (p = 0.016) and high Ki67 proliferation index (p = 0.015) but not with clinical T stage, N stage, and ER and HER2 statuses.

Conclusions

The SUVmax of DbPET correlates with clinicopathological factors and also WBPET does. In addition, intratumoral heterogeneity on DbPET provides predictive value for malignancy grade and could inform therapeutic decisions.

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Abbreviations

ER:

Estrogen receptor

DbPET:

Dedicated breast positron emission tomography

FDG:

18F-fluorodeoxyglucose

HER2:

Human epidermal growth factor receptor type 2

WBPET:

Whole-body positron emission tomography

PET/CT:

Positron emission tomography/computed tomography

SUVmax:

Maximum standardized uptake value

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Acknowledgements

We thank Kazushi Marukawa and Masatsugu Tsujimura of Chuden Hospital for providing data regarding PET examinations.

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Authors and Affiliations

  1. Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3-Kasumi, Minami-ku, Hiroshima, 734-0037, Japan

    Norio Masumoto, Takayuki Kadoya, Shinsuke Sasada, Akiko Emi & Morihito Okada

  2. Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan

    Koji Arihiro

Authors
  1. Norio Masumoto
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  2. Takayuki Kadoya
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  3. Shinsuke Sasada
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  4. Akiko Emi
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  6. Morihito Okada
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Correspondence to Norio Masumoto.

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Masumoto, N., Kadoya, T., Sasada, S. et al. Intratumoral heterogeneity on dedicated breast positron emission tomography predicts malignancy grade of breast cancer. Breast Cancer Res Treat 171, 315–323 (2018). https://doi.org/10.1007/s10549-018-4791-1

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  • DOI: https://doi.org/10.1007/s10549-018-4791-1

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