Diagnostics (Feb 2024)

Correlation between Histopathological Prognostic Tumor Characteristics and [<sup>18</sup>F]FDG Uptake in Corresponding Metastases in Newly Diagnosed Metastatic Breast Cancer

  • Jorianne Boers,
  • Bertha Eisses,
  • Mieke C. Zwager,
  • Jasper J. L. van Geel,
  • Frederike Bensch,
  • Erik F. J. de Vries,
  • Geke A. P. Hospers,
  • Andor W. J. M. Glaudemans,
  • Adrienne H. Brouwers,
  • Martijn A. M. den Dekker,
  • Sjoerd G. Elias,
  • Evelien J. M. Kuip,
  • Carla M. L. van Herpen,
  • Agnes Jager,
  • Astrid A. M. van der Veldt,
  • Daniela E. Oprea-Lager,
  • Elisabeth G. E. de Vries,
  • Bert van der Vegt,
  • Willemien C. Menke-van der Houven van Oordt,
  • Carolina P. Schröder

DOI
https://doi.org/10.3390/diagnostics14040416
Journal volume & issue
Vol. 14, no. 4
p. 416

Abstract

Read online

Background: In metastatic breast cancer (MBC), [18F]fluorodeoxyglucose positron emission tomography/computed tomography ([18F]FDG-PET/CT) can be used for staging. We evaluated the correlation between BC histopathological characteristics and [18F]FDG uptake in corresponding metastases. Patients and Methods: Patients with non-rapidly progressive MBC of all subtypes prospectively underwent a baseline histological metastasis biopsy and [18F]FDG-PET. Biopsies were assessed for estrogen, progesterone, and human epidermal growth factor receptor 2 (ER, PR, HER2); Ki-67; and histological subtype. [18F]FDG uptake was expressed as maximum standardized uptake value (SUVmax) and results were expressed as geometric means. Results: Of 200 patients, 188 had evaluable metastasis biopsies, and 182 of these contained tumor. HER2 positivity and Ki-67 ≥ 20% were correlated with higher [18F]FDG uptake (estimated geometric mean SUVmax 10.0 and 8.8, respectively; p = 0.0064 and p = 0.014). [18F]FDG uptake was lowest in ER-positive/HER2-negative BC and highest in HER2-positive BC (geometric mean SUVmax 6.8 and 10.0, respectively; p = 0.0058). Although [18F]FDG uptake was lower in invasive lobular carcinoma (n = 31) than invasive carcinoma NST (n = 146) (estimated geometric mean SUVmax 5.8 versus 7.8; p = 0.014), the metastasis detection rate was similar. Conclusions: [18F]FDG-PET is a powerful tool to detect metastases, including invasive lobular carcinoma. Although BC histopathological characteristics are related to [18F]FDG uptake, [18F]FDG-PET and biopsy remain complementary in MBC staging (NCT01957332).

Keywords