title: Correlation of the value of 18F-FDG uptake, described by SUVmax, SUVavg, metabolic tumour volume and total lesion glycolysis, to clinicopathological prognostic factors and biological subtypes in breast cancer.
abstract: OBJECTIVE
  The aim of this study was to observe the relationships between different metabolic parameters and clinicopathological features (CPFs) or immunohistochemically defined biological subtypes (IHC-BS) in breast cancer.
  
  
  METHODS
  Eighty-two women (83 lesions, tumour size>15 mm) underwent PET/computed tomography imaging after a core biopsy. Maximum and average standardized uptake values (SUVmax, SUVavg), metabolic tumour volume (MTV) and total lesion glycolysis (TLG) in the primary tumour were calculated and compared with CPFs and IHC-BS. Tumours with oestrogen receptor (ER) positivity were separately investigated in relation to their progesterone receptor (PR) status.
  
  
  RESULTS
  Significant correlation was found between all metabolic parameters and high nuclear grade or ER status or IHC-BS. All parameters were higher in PR(-) and triple-negative cases than in PR(+) and non-triple-negative tumours, and the correlation was significant for most of the metabolic parameters (except for SUVavg in the case of PR status and MTV in the case of triple negativity). Significant correlation was found only for SUVmax regarding the human epidermal growth factor receptor 2 (HER2) status. There was moderate correlation between the Ki67 expression and the SUVmax or SUVavg. All metabolic parameters were higher in ER(+)/PR(-)/HER2(-) lesions compared with ER(+)/PR(+)/HER2(-) cancers. However, ER(+)/PR(-)/HER2(+) tumours had lower SUVmax and SUVavg compared with ER(+)/PR(+)/HER2(+) lesions.
  
  
  CONCLUSIONS
  Our study confirms that the fluorine-18 fluorodeoxyglucose uptake in primary tumour is associated with distinct CPFs or IHC-BS in breast cancer. SUVmax may reflect tumour metabolism more reliably compared with SUVavg, MTV or total lesion glycolysis. Our preliminary results suggest different biological properties in ER(+) tumours with different PR statuses.
authors.affiliation: aPozitron PET/CT Centre bOncological Division of 1st Department of Internal Medicine c2nd Department of Pathology, Semmelweis University, Budapest, Hungary.
authors.forename: Kornélia
authors.initials: K
authors.lastname: Kajáry
authors.forename: Tímea
authors.initials: T
authors.lastname: Tőkés
authors.forename: Magdolna
authors.initials: M
authors.lastname: Dank
authors.forename: Janina
authors.initials: J
authors.lastname: Kulka
authors.forename: Szabolcs
authors.initials: S
authors.lastname: Szakáll
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Lengyel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001692:Biological Transport; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D006019:Glycolysis; D006801:Humans; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011379:Prognosis; D012372:ROC Curve; D011960:Receptors, Estrogen / Q000378:metabolism; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
chemical_list: D011960:Receptors, Estrogen; D019788:Fluorodeoxyglucose F18