title: Correlation of the SUVmax of FDG-PET and ADC values of diffusion-weighted MR imaging with pathologic prognostic factors in breast carcinoma.
abstract: OBJECTIVE
  To correlate both primary lesion maximum standardized uptake values (SUVmax) of FDG-PET/CT, and apparent diffusion coefficient (ADC) values of diffusion-weighted imaging (DWI) with clinicopathologic prognostic factors in patients with breast carcinoma.
  
  
  METHODS
  214 patients with 216 mass-type invasive breast carcinomas underwent whole-body FDG-PET/CT and 3-Tesla breast MRI including DWI before initial therapy. The primary tumor's SUVmax and ADC values were measured using FDG-PET/CT and DWI, respectively. Histologic analysis parameters included tumor size, expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67, nuclear grade, histology subtype, and axillary lymph node (LN) metastasis. The relationships among SUVmax, ADC values, and pathologic prognostic factors were evaluated.
  
  
  RESULTS
  The mean SUVmax and ADCmean were 5.63±3.79 (range, 1.2-24.17) and 894±204×10(-6)mm(2)/s (range, 452-1550×10(-6)), respectively. There was a significant but weak inverse correlation between the SUVmax and ADCmean values (correlation coefficient r=-0.30, p<0.0001). SUVmax was associated with numerous prognostic factors such as tumor size (p<0.0001), expression levels of ER (p=0.00041), PR (p=0.00028), HER2 (p=0.00021), and Ki-67 (p<0.0001), nuclear grade (p<0.0001), histology subtype (p=0.00061), axillary LN metastasis (p<0.0001), and TNM staging (p<0.0001). Meanwhile, ADCmean value was associated with tumor size (p=0.013), expression of Ki-67 (p=0.0010), histology subtype (p=0.00013), axillary LN metastasis (p=0.00059), and TNM staging (p=0.0011).
  
  
  CONCLUSIONS
  Primary tumor SUVmax on FDG-PET/CT has a stronger relationship with known prognostic parameters and may be a more useful for predicting the prognosis of breast carcinoma than ADC values.
authors.affiliation: Department of Nuclear Medicine and PET center, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, JAPAN. Electronic address: zu10041976@yahoo.co.jp.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kitajima
authors.affiliation: Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, JAPAN. Electronic address: t-yama@hyo-med.ac.jp.
authors.forename: Toshiko
authors.initials: T
authors.lastname: Yamano
authors.affiliation: Department of Nuclear Medicine and PET center, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, JAPAN. Electronic address: fukuchan0106@gmail.com.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Fukushima
authors.affiliation: Department of Breast and Endocrine Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, JAPAN. Electronic address: ymiyoshi@hyo-med.ac.jp.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Miyoshi
authors.affiliation: Department of Surgical Pathology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, JAPAN. Electronic address: hiros@hyo-med.ac.jp.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Hirota
authors.affiliation: Department of Nuclear Medicine and PET center, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, JAPAN. Electronic address: n_you_634@yahoo.co.jp.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kawanaka
authors.affiliation: Department of Nuclear Medicine and PET center, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, JAPAN. Electronic address: m-mou@hyo-med.ac.jp.
authors.forename: Mouri
authors.initials: M
authors.lastname: Miya
authors.affiliation: Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, JAPAN. Electronic address: h-doi@hyo-med.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Doi
authors.affiliation: Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, JAPAN. Electronic address: ko-yamakado@hyo-med.ac.jp.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yamakado
authors.affiliation: Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, JAPAN. Electronic address: hirota-s@hyo-med.ac.jp.
authors.forename: Shozo
authors.initials: S
authors.lastname: Hirota
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000000981:diagnostic imaging / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D008875:Middle Aged; D064847:Multimodal Imaging; D000072078:Positron Emission Tomography Computed Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D051598:Whole Body Imaging
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: ADC; Breast carcinoma; FDG-PET/CT; Prognosis; SUVmax