Chonnam Med J.  2017 May;53(2):133-139. 10.4068/cmj.2017.53.2.133.

Correlation of Prognostic Factors of Invasive Lobular Carcinoma with ADC Value of DWI and SUVMax of FDG-PET

• Choi BB
• Kim SH
• Park CS
• Jung NY

• KMID: 2379286
• DOI: http://doi.org/10.4068/cmj.2017.53.2.133

Abstract

Invasive lobular carcinoma (ILC) is the second most common kind of breast cancer. Diffusion weighted imaging (DWI) and positron emission tomography/computed tomography (PET/CT) are functional modalities for presenting the biological characteristics of breast cancer. The purpose of this article is to study the relationship between DWI or PET/CT and ILC's prognostic factors. The relationship between the apparent diffusion coefficient (ADC) values, standard uptake value (SUV)max and prognostic factors of ILC were statistically evaluated. The ADC values were lower in mass types of ILC. SUVmax was statistically higher in grade 3 and 4 background parenchymal enhancement and positive lymph node metastasis. ADC values of DWI and SUVmax of PET/CT can be helpful in the prediction of the prognosis of ILC.

Keyword

Invasive Lobular Carcinoma; Breast; Magnetic Resonance Imaging; Diffusion Magnetic Resonance Imaging; Positron-Emission Tomography

MeSH Terms

Breast
Breast Neoplasms
Carcinoma, Lobular*
Diffusion
Diffusion Magnetic Resonance Imaging
Electrons
Lymph Nodes
Magnetic Resonance Imaging
Neoplasm Metastasis
Population Characteristics
Positron-Emission Tomography
Positron-Emission Tomography and Computed Tomography
Prognosis

Figure

• 

  FIG. 1 A 64-year-old woman with invasive lobular carcinoma of the left breast. (A) ADC map shows RIO for measuring the mean ADC value. The calculated ADC value was 1,115×10−6 mm2/s, which was slightly higher than mean ADC value (1,117×10−6 mm2/s). (B) Axial enhanced T1-weighted image after two minutes of contrast injection demonstrates an irregular heterogeneous enhancing mass in the left breast. Background parenchymal enhancement was grade 3, moderate enhancement. (C) FDG PET/CT image shows FDG uptake in the left breast with measured SUVmax as 3.7. On histologic examination, axillary LN metastasis was noted in two LNs. The results of immunohistochemical study were ER (+), PR (+), HER2 (−), EGFR (+) and Ki-67 2%. ADC: apparent diffusion coefficient, EGFR: epidermal growth factor receptor, ER: estrogen receptor, FDG PET/CT: 18 F-fluorodeoxygluxose positron emission tomography/computed tomography, HER2: human epidermal growth factor receptor 2, EGFR: epidermal growth factor receptor, LN: lymph node, PR: progesterone receptor, SUVmax: maximum standardized uptake value.

• 

  FIG. 2 A 71-year-old woman with invasive lobular carcinoma of the right breast. (A) On ADC map, calculated ADC value by ROI was 1,260×10−6 mm2/s, which was higher than mean ADC value (1,117×10−6 mm2/s). (B) Axial enhanced T1-weighted image shows nonmass like enhancement in the right breast. BPE was grade 1, minimal enhancement. (C) FDG PET/CT image shows minimal FDG uptake in the right breast with measured SUVmas as 1.3. On histologic examination, there was no axillary LN metastasis. Immunohistochemical study showed ER (+), PR (−), HER2 (−), EGFR (+) and Ki-67 10%. ADC: apparent diffusion coefficient, EGFR: epidermal growth factor receptor, ER: estrogen receptor, FDG PET/CT: 18 F-fluorodeoxygluxose positron emission tomography/computed tomography, HER2: human epidermal growth factor receptor 2, EGFR: epidermal growth factor receptor, LN: lymph node, PR: progesterone receptor, SUVmax: maximum standardized uptake value.

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