Open AccessComparative study of the value of dual tracer PET / CT in evaluating breast cancer
Author(s) -
Tateishi Ukihide,
Terauchi Takashi,
AkashiTanaka Sadako,
Kinoshita Takayuki,
Kano Daisuke,
Daisaki Hiromitsu,
Murano Takeshi,
Tsuda Hitoshi,
Macapinlac Homer A.
Publication year - 2012
Publication title -
cancer science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.035
H-Index - 141
eISSN - 1349-7006
pISSN - 1347-9032
DOI - 10.1111/j.1349-7006.2012.02348.x
Subject(s) - medicine , breast cancer , nuclear medicine , standardized uptake value , confidence interval , odds ratio , logistic regression , pet ct , cancer , primary tumor , radiology , positron emission tomography , pathology , metastasis
The present study was conducted to assess the relationship between tumor uptake and pathologic findings using dual‐tracer PET /computed tomography ( CT ) in patients with breast cancer. Seventy‐four patients with breast cancer (mean age 54 years) who underwent 11 C ‐choline and 2‐[ 18 F ]fluoro‐2‐deoxy‐ d ‐glucose ( 18 F ‐ FDG ) PET / CT prior to surgery on the same day were enrolled in the present study. Images were reviewed by a board‐certified radiologist and two nuclear medicine specialists who were unaware of any clinical information and a consensus was reached. Uptake patterns and measurements of dual tracers were compared with the pathologic findings of resected specimens as the reference standard. Mean (± SD ) tumor size was 5.9 ± 3.2 cm. All primary tumors were identified on 18 F ‐ FDG PET / CT and 11 C ‐choline PET / CT . However, 18 F ‐ FDG PET / CT demonstrated focal uptake of the primary tumor with ( n = 38; 51%) or without ( n = 36; 49%) diffuse background breast uptake. Of the pathologic findings, multiple logistic regression analysis revealed an independent association between fibrocystic change and diffuse background breast uptake (odds ratio [ OR ] 8.57; 95% confidence interval [ CI ] 2.86–25.66; P < 0.0001). Tumors with higher histologic grade, nuclear grade, structural grade, nuclear atypia, and mitosis had significantly higher maximum standardized uptake values ( SUV max ) and tumor‐to‐background ratios ( TBR ) for both tracers. Multiple logistic regression analysis revealed that only the degree of mitosis was independently associated with a high SUV max ( OR 7.45; 95% CI 2.21–25.11; P = 0.001) and a high TBR ( OR 5.41; 95% CI 1.13–25.96; P = 0.035) of 11 C ‐choline PET / CT . In conclusion, 11 C ‐choline may improve tumor delineation and reflect tumor aggressiveness on PET / CT in patients with breast cancer.