Semi-quantitative lymph node assessment of (18)F-FDG PET/CT in locally advanced breast cancer: correlation with biological prognostic factors.
OBJECTIVE
The aim of this study was to analyse the correlation between dual-time-point (18)F-2-deoxy-2-fluoro-D-glucose (FDG) uptakes in lymph nodes assessed by positron emission tomography (PET)/CT and histopathological and immunohistochemical prognostic factors.


METHODS
Seventy-five women with locally advanced breast cancer were prospectively evaluated. PET/CT was requested in the initial staging previous to adjuvant chemotherapy (multicentre study). All of the patients underwent (18)F-FDG PET/CT with a dual-time-point acquisition. Both examinations were evaluated qualitatively and semi-quantitatively with calculation of maximum standardized uptake values (SUV(max)) in PET-1 (SUV-1) and in PET-2 (SUV-2) and the percentage variation of the SUV or retention index (RI) between PET-1 and PET-2 in lymph nodes with the greater (18)F-FDG uptake. The biological prognostic parameters such as the steroid receptor status, p53 and HER2 expression, proliferation rate (Ki-67) and grading were determined from tissue of the primary tumour. Metabolic and biological parameters were correlated using Spearman's rank-order correlation coefficient and Mann-Whitney U and Kruskal-Wallis tests.


RESULTS
Negative receptor status was correlated with higher SUV-1, SUV-2 and RI in lymph nodes. The results were significant for progesterone receptor status. p53 over-expression and triple-negative status were associated with greater semi-quantitative parameters in lymph nodes. Higher tumoural grades were related with greater semi-quantitative parameters (p > 0.05).


CONCLUSIONS
Biological factors of bad prognosis were correlated with higher semi-quantitative metabolic values in lymph nodes. Therefore these results appear to reveal biological significance of lymph node (18)F-FDG accumulation.
Nuclear Medicine Department, University General Hospital, C/ Obispo Rafael Torija s/n, Ciudad Real, Spain. angarvice@yahoo.es
Ana María
AM
García Vicente
Angel
A
Soriano Castrejón
Miguel Angel
MA
Cruz Mora
Ana
A
González Ageitos
María del Mar
Mdel M
Muñoz Sánchez
Alberto
A
León Martín
Ruth
R
Espinosa Aunión
Fernanda
F
Relea Calatayud
Vicente
V
Muñoz Madero
Ignacio
I
Chacón López-Muñiz
Jose Manuel
JM
Cordero García
Germán Andrés
GA
Jiménez Londoño
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000737:chemistry / Q000000981:diagnostic imaging* / Q000628:therapy; D049109:Cell Proliferation; D017024:Chemotherapy, Adjuvant; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D011987:Receptors, Steroid / Q000032:analysis; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
D019788:Fluorodeoxyglucose F18; D018719:Erb-b2 Receptor Tyrosine Kinases; D011987:Receptors, Steroid; D016159:Tumor Suppressor Protein p53; C508053:ERBB2 protein, human