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Jeong, Lee, Park, Lee, Yi, and Choi: Factors Affecting 18F-Fluorodeoxyglucose (FDG) Uptake in Breast Cancer
Breast Radiology
Original Article

Journal of the Korean Society of Radiology 2010; 63(3): 287-292.

Published online: 30 September 2010

DOI: https://doi.org/10.3348/jksr.2010.63.3.287

Factors Affecting 18F-Fluorodeoxyglucose (FDG) Uptake in Breast Cancer

Sun Hye Jeong, M.D., Eun Hye Lee, M.D., Jung Mi Park, M.D.2, Hae Kyung Lee, M.D., Boem Ha Yi, M.D., Nami Choi, M.D.3

1Department of Radiology, Soonchunhyang University Bucheon Hospital, Korea.

2Department of Nuclear Medicine, Soonchunhyang University Bucheon Hospital, Korea.

3Department of Radiology, Konkuk University Hospital, Korea.

Address reprint requests to: Eun Hye Lee, M.D., Department of Radiology, Soonchunhyang University Bucheon Hospital 1174 Jung-dong, Wonmi-gu, Bucheon-si, Gyeonggi-do 420-767, Korea. Tel. 82-32-621-5851, Fax. 82-32-621-5874, grace@schbc.ac.kr

Received 8 September 2009       Accepted 20 June 2010

Copyright © 2010 The Korean Society of Radiology

Abstract

Purpose

To evaluate factors affecting 18F-Fluorodeoxyglucose (FDG) uptake in breast cancer.

Materials and Methods

For 3 years from 2006, 180 patients (mean age 48-years-old) with 187 breast cancers underwent positron emission tomography-computed tomography (PET/CT; biograph2, Siemens) at our institute and were enrolled in this study. We evaluated whether there was a correlation between the peak standardized uptake value (pSUV) of PET/CT and the histologic type of the breast cancers (n=187), grade of the invasive ductal cancers (n=142), and tumor size (n=153).

Results

The different histologic types of breast cancers include IDCs (n=156), in situ ductal carcinoma (n=10), papillary cancer (n=6), mucinous cancer (n=6), invasive lobular cancer (n=4), medullary cancer (n=3), metaplastic cancer (n=1), and neuroendocrine cancer (n=1). pSUV showed significant differences according to histologic type (p<0.005). For the available cases (n=142), IDCs were classified as grade 1 (n=25), grade 2 (n=66), and grade 3 (n=51) and correlated with the histologic grade of IDCs (rho=0.41, p<0.001). pSUV was correlated with tumor size regardless of histologic type (rho=0.525, p<0.001). In low grade IDCs, pSUV was correlated with tumor size (rho=0.48-0.86, p<0.001), but not in high grade IDCs (p>0.001).

Conclusion

Regardless of histologic type, the larger the breast cancer, the higher the pSUV; in addition, the higher the grade of IDCs, the higher the pSUV. For the low grade IDCs, pSUV is correlated with tumor size; however, this is not the case in high grade IDCs.

Keywords: Breast Neoplasms, Positron-Emission Tomography, Fluorodeoxyglucose F18

Figures and Tables

Fig. 1

Measure of volumes of interest (VOI) on PET image.

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Fig. 2

pSUV of IDCs according to histologic grading.

A-C. Within IDCs, pSUV was significantly correlated with histologic grading. (A) PET/CT image of 44-year-old woman having IDC grade 1 in upper inner quadrant of left breast and performed left mastectomy. pSUV of cancer was 2.6 and the histologic size was 2 cm. (B) PET/CT image of 28-year-old woman having IDC grade 2 in upper outer quadrant of left breast and performed breast conserving surgery. pSUV of cancer was 5.0 and the histologic size was 2 cm. (C) PET/CT image of 56-year-old woman having IDC grade 3 in upper outer quadrant of right breast and performed left mastectomy. pSUV of cancer was 10.9 and the histologic size was 2 cm.
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Fig. 3

Distribution of breast cancers according to size of tumor and pSUV.

Regardless of histology, pSUV was correlated with tumor size (rho=0.525, p<0.001).
Note: pSUV=peak standardized uptake value, IDC=invasive ductal carcinoma, DCIS=ductal carcinoma in situ, NDIC=non-ductal invasive cancer
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Table 1

Comparison of Histology, Size, and pSUV of Breast Cancers

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Note.─ pSUV=peak standardized uptake value, IDC=invasive ductal carcinoma, DCIS=ductal carcinoma in situ, ILC=invasive lobular carcinoma

Table 2

Comparison of Histologic Grading and pSUV of IDCs

jksr-63-287-i002

pSUV was correlated with histologic grade of IDCs.

Note.─ IDC=invasive ductal carcinoma, Rho=Spearman's correlation coefficient

Table 3

Comparison of Size and pSUV of IDCs

jksr-63-287-i003

In IDCs grade 1 and 2, pSUV was correlated with tumor size, but not in IDCs grade 3.

Note.─ Rho=Spearman's correlation coefficient

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