Abstract

BackgroundTo help interpret measurements in breast tissue and breast tumors from 18F-FDG PET scans, we studied the influence of age in measurements of PET parameters in normal breast tissue and in a breast cancer (BC) population.Results522 women were included: 331 pts without history of BC (B-VOI) and 191 patients with BC (T-VOI). In B-VOI, there were significant differences between all age groups for Standardized Uptake Values (SUVs) and for 12 textural indices (TI) whereas histogram-based indices (HBI) did not vary between age groups. SUV values decreased over time whereas Homogeneity increased. We had a total of 210 T-VOI and no significant differences were found according to the histological type between 190 ductal carcinoma and 18 lobular carcinoma. Conversely, according to BC subtype most differences in PET parameters between age groups were found in Triple-Negative tumors (52) for 9 TI. On post-hoc Hochberg, most differences were found between the <45 year old (PRE) group and POST groups in NBT and in Triple-Negative tumors.ConclusionWe found significant SUVs and TI differences as a function of age in normal breast tissue and in BC radiomic phenotype with Triple-Negative tumors being the most affected. Our findings suggest that age should be taken into account as a co-covariable in radiomic models.MethodsPatients were classified in 3 age groups: <45 yo (PRE), ≥45 and <55 yo (PERI) and ≥55 and <85 yo (POST) and we compared PET parameters using Anova test with post-hoc Bonferroni/Hochberg analyses: SUV (max, mean and peak), HBI and TI in both breasts and in breast tumor regions.

Highlights

  • Breast cancer (BC) is the most frequent cancer in western countries representing ~25% of cancer in women and remains a leading cause of death by cancer estimated at ~15% of all deaths by cancer in 2012 [1, 2]. 18F-fluorodeoxyglucose positron emission tomography/ computed tomography (18F-FDG 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT)) is currently widely used in locally advanced breast cancer for initial staging, tumor response assessment or for detection of recurrence [3, 4, 5, 6]

  • We had a total of 210 T-VOI and no significant differences were found according to the histological type between 190 ductal carcinoma and 18 lobular carcinoma

  • To the best of our knowledge, we demonstrated for the first-time significant differences in Standardized Uptake Values (SUVs), histogram-based indices (HBI) and textural indices (TI) in normal breast tissue according to age in 18F-FDG PET images

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Summary

Introduction

Breast cancer (BC) is the most frequent cancer in western countries representing ~25% of cancer in women and remains a leading cause of death by cancer estimated at ~15% of all deaths by cancer in 2012 [1, 2]. 18F-fluorodeoxyglucose positron emission tomography/ computed tomography (18F-FDG PET/CT) is currently widely used in locally advanced breast cancer for initial staging, tumor response assessment or for detection of recurrence [3, 4, 5, 6]. Breast cancer is a very heterogeneous disease and current RF such as SUVmax and MTV do not reflect tumor heterogeneity [9]. We hypothesize that TI extracted from normal or pathological breast tissue in PET may vary according to physiological changes in women’s life [12, 13, 14, 15], possibly introducing a confounding factor in their interpretation. It is known in the literature that significant changes occur in breast tissue function and architecture throughout various periods of women’s life, the influence of age in RF variations has not been explored in 18F-FDG PET/CT. To help interpret measurements in breast tissue and breast tumors from 18F-FDG PET scans, we studied the influence of age in measurements of PET parameters in normal breast tissue and in a breast cancer (BC) population

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