title: Positron emission mammography: correlation of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 status and 18F-FDG.
abstract: OBJECTIVE
  The study objective was to assess the correlation between (18)F-FDG uptake values on positron emission mammography (PEM), expressed as maximum uptake value and lesion-to-background ratio, and receptor status (i.e., estrogen receptor [ER], progesterone receptor [PR], and human epidermal growth factor receptor 2 [HER2]), tumor histology, and tumor grade. We also evaluated for the correlation between maximum uptake value on PEM and maximum uptake value on a whole-body PET/CT.
  
  
  METHODS
  We retrospectively reviewed our database for patients with newly diagnosed breast cancer who were referred for PEM between June 2007 and September 2009. A subset of patients also underwent a whole-body PET/CT scan. The original pathology reports were reviewed to establish the histologic type, grade, and receptor status.
  
  
  RESULTS
  The study involved 98 patients with 100 lesions. ER-negative tumors and PR-negative tumors had significantly higher mean lesion-to-background ratio than did their respective receptor-positive tumors (p = 0.02). Triple-negative tumors (i.e., ER-negative, PR-negative, and HER2-negative tumors) had statistically higher mean lesion-to-background ratio than did ER-positive PR-positive HER2-negative tumors (p = 0.04). Infiltrating ductal carcinomas had significantly higher PEM FDG uptake values than did infiltrating lobular carcinomas (p = 0.02-0.04). Breast tumors with higher histologic grade also had significantly higher PEM FDG uptake values than did those with lower grade (p = 0.03 and p < 0.001). A moderately high correlation (0.76-0.79) was seen between whole-body PET/CT and PEM uptake values.
  
  
  CONCLUSIONS
  This study shows a correlation between PEM FDG uptake values and the prognostic factors that have been shown to predict breast cancer survival.
authors.affiliation: 1Seattle Nuclear Medicine/Swedish Cancer Institute, 1229 Madison St, Ste 1050, Seattle, WA 98104-3306, USA.
authors.forename: Carolyn L
authors.initials: CL
authors.lastname: Wang
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: MacDonald
authors.forename: James V
authors.initials: JV
authors.lastname: Rogers
authors.forename: Aleksandr
authors.initials: A
authors.lastname: Aravkin
authors.forename: David R
authors.initials: DR
authors.lastname: Haseley
authors.forename: J David
authors.initials: JD
authors.lastname: Beatty
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D019540:Area Under Curve; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D012372:ROC Curve; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D011960:Receptors, Estrogen / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000378:metabolism*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D051598:Whole Body Imaging
chemical_list: D019788:Fluorodeoxyglucose F18; D019275:Radiopharmaceuticals; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone