Abstract
Purpose18F-Fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging (18F-FDG PET/CT) is an important diagnostic tool in breast cancer. The utility of maximum standardized uptake values (SUVmax) of primary tumors has been evaluated to predict sentinel node (SN) and non-SN metastasis in clinically node-negative (cN0) patients.Patients and Methods18F-FDG PET/CT was performed on 414 cN0 patients. The following parameters were evaluated: SUVmax at 60 min (SUVmax1), SUVmax at 120 min (SUVmax2), percent change between SUVmax1 and SUVmax2 (ΔSUVmax%), SN metastasis foci maximum size (SN meta size), and ratio of metastatic SNs to total SNs or SN ratio (SNR). It was assessed whether these were risk factors for SN metastasis. The relationship between these parameters and the status of SN and/or non-SN metastasis was retrospectively explored to predict non-SN metastasis.ResultsAll SUV parameters significantly correlated with pathological T factor (pT), nuclear grade, lymphatic invasion (Ly), and Ki-67 labeling index. On multivariate analysis, pT and Ly were independent predictive factors for SN metastasis. In SN meta-positive cases, SN meta size, SNR, and ΔSUVmax% were predictors for non-SN metastasis on univariate analyses, and the former two were independent predictors on multivariate analysis. The combination of SUVmax2 and ΔSUVmax% was an independent predictor of non-SN metastasis (P = 0.0312) and was associated with prediction of non-SN metastasis negative status with high probability (92.3%).ConclusionsIn patients with cN0 breast cancer, SUV parameters of the primary tumor were correlated with pathological features. The combination of SUVmax2 and ΔSUVmax% may be useful for predicting non-SN metastasis.
Highlights
Breast cancer is one of the most frequent malignant diseases and the fifth leading cause of cancer death in Japanese women.1 18F-Fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging (18F-FDG PET/CT) has come to play an increasing role in the diagnosis of biological properties of primary breast cancer as well as staging, treatment monitoring of residual disease, and detection of disease recurrence.[2,3] Many
The aim of this study is to investigate whether the prediction of sentinel node (SN) and non-SN metastasis is possible by the examination of SUV parameters in the primary tumor
The significance of SUV parameters in primary tumor for SN and/or non-SN metastasis was evaluated in patients with cN0 breast cancer
Summary
Breast cancer is one of the most frequent malignant diseases and the fifth leading cause of cancer death in Japanese women.1 18F-Fluorodeoxyglucose positron emission tomography/computed tomography fusion imaging (18F-FDG PET/CT) has come to play an increasing role in the diagnosis of biological properties of primary breast cancer as well as staging, treatment monitoring of residual disease, and detection of disease recurrence.[2,3] Many. Sentinel node biopsy (SNB) is a standard technique for patients with clinically node-negative (cN0) breast cancer,[11] and axillary lymph node dissection (ALND) may be considered when macrometastasis is observed in a SN. As the result of the American College of Surgeons Oncology Group Z0011 trial,[14] axillary dissection in clinically node-negative individuals has come to be less common, and ALND has come to be optional for the patients who had SN-metastasis positive in two or less nodes, underwent breast-conserving surgery, and received whole-breast irradiation with adjuvant systemic therapy. The aim of this study is to investigate whether the prediction of SN and non-SN metastasis is possible by the examination of SUV parameters in the primary tumor
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