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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?

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

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.

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Compliance with ethical standards

Funding

This work received French government support granted to the CominLabs excellence laboratory and managed by the National Research Agency in the "Investing for the Future" programme under reference ANR-10-LABX-07-01.

Conflicts of interest

None.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. For this retrospective study formal consent was not required.

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    Authors and Affiliations

    1. Department of Nuclear Medicine, Saint-Louis Hospital, Paris, France

      David Groheux, Antoine Martineau & Pascal Merlet

    2. INSERM, UMR 1101 LaTIM, CHRU Morvan, 2 avenue Foch, 29609, Brest, France

      Mohamed Majdoub, Mathieu Hatt & Dimitris Visvikis

    3. DACTIM, Department of Nuclear Medicine, Milétrie Hospital, Poitiers, France

      Florent Tixier & Catherine Cheze Le Rest

    4. Breast Diseases Unit and Department of Medical Oncology, Saint-Louis Hospital, Paris, France

      Marc Espié

    5. Department of Pathology, Saint-Louis Hospital, Paris, France

      Anne de Roquancourt

    6. Department of Nuclear Medicine, CHU Bordeaux, University of Bordeaux, Bordeaux, France

      Elif Hindié

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    1. David Groheux
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    Correspondence to Mathieu Hatt.

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    Mathieu Hatt and Dimitris Visvikis contributed equally to this work.

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    Groheux, D., Majdoub, M., Tixier, F. et al. 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?. Eur J Nucl Med Mol Imaging 42, 1682–1691 (2015). https://doi.org/10.1007/s00259-015-3110-x

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