J Korean Soc Radiol.  2010 Sep;63(3):287-292. 10.3348/jksr.2010.63.3.287.

Factors Affecting 18F-Fluorodeoxyglucose (FDG) Uptake in Breast Cancer

• Jeong SH
• Lee EH
• Park JM
• Lee HK
• Yi BH
• Choi N

• KMID: 2097907
• DOI: http://doi.org/10.3348/jksr.2010.63.3.287

Abstract

PURPOSE: To evaluate factors affecting 18F-Fluorodeoxyglucose (FDG) uptake in breast cancer.
MATERIALS AND METHODS
For 3 years from 2006, 180 patients (mean age 48-years-old) with 187 breast cancers underwent positron emission tomography-computed tomography (PET/CT; biograph2, Siemens) at our institute and were enrolled in this study. We evaluated whether there was a correlation between the peak standardized uptake value (pSUV) of PET/CT and the histologic type of the breast cancers (n=187), grade of the invasive ductal cancers (n=142), and tumor size (n=153).
RESULTS
The different histologic types of breast cancers include IDCs (n=156), in situ ductal carcinoma (n=10), papillary cancer (n=6), mucinous cancer (n=6), invasive lobular cancer (n=4), medullary cancer (n=3), metaplastic cancer (n=1), and neuroendocrine cancer (n=1). pSUV showed significant differences according to histologic type (p<0.005). For the available cases (n=142), IDCs were classified as grade 1 (n=25), grade 2 (n=66), and grade 3 (n=51) and correlated with the histologic grade of IDCs (rho=0.41, p<0.001). pSUV was correlated with tumor size regardless of histologic type (rho=0.525, p<0.001). In low grade IDCs, pSUV was correlated with tumor size (rho=0.48-0.86, p<0.001), but not in high grade IDCs (p>0.001).
CONCLUSION
Regardless of histologic type, the larger the breast cancer, the higher the pSUV; in addition, the higher the grade of IDCs, the higher the pSUV. For the low grade IDCs, pSUV is correlated with tumor size; however, this is not the case in high grade IDCs.

MeSH Terms

Breast
Breast Neoplasms
Carcinoma, Ductal
Electrons
Fluorodeoxyglucose F18
Humans
Mucins
Positron-Emission Tomography
Fluorodeoxyglucose F18
Mucins

Figure

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  Fig. 1 Measure of volumes of interest (VOI) on PET image.

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  Fig. 2 pSUV of IDCs according to histologic grading. A-C. Within IDCs, pSUV was significantly correlated with histologic grading. (A) PET/CT image of 44-year-old woman having IDC grade 1 in upper inner quadrant of left breast and performed left mastectomy. pSUV of cancer was 2.6 and the histologic size was 2 cm. (B) PET/CT image of 28-year-old woman having IDC grade 2 in upper outer quadrant of left breast and performed breast conserving surgery. pSUV of cancer was 5.0 and the histologic size was 2 cm. (C) PET/CT image of 56-year-old woman having IDC grade 3 in upper outer quadrant of right breast and performed left mastectomy. pSUV of cancer was 10.9 and the histologic size was 2 cm.

• 

  Fig. 3 Distribution of breast cancers according to size of tumor and pSUV. Regardless of histology, pSUV was correlated with tumor size (rho=0.525, p<0.001). Note: pSUV=peak standardized uptake value, IDC=invasive ductal carcinoma, DCIS=ductal carcinoma in situ, NDIC=non-ductal invasive cancer

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