Predictive value of 18 F-fluorodeoxyglucose uptake for axillary lymph node metastasis in operable breast cancer: impact of molecular subtypes.

Autor: Lim CH; Department of Nuclear Medicine, Soonchunhyang University Seoul Hospital, Seoul, 04401, Republic of Korea., Lee JH; Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, 04401, Republic of Korea., Lee J; Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, 04401, Republic of Korea., Park SB; Department of Nuclear Medicine, Soonchunhyang University Seoul Hospital, Seoul, 04401, Republic of Korea. soobin.park@schmc.ac.kr.
Jazyk: angličtina
Zdroj: Annals of nuclear medicine [Ann Nucl Med] 2024 Dec 02. Date of Electronic Publication: 2024 Dec 02.
DOI: 10.1007/s12149-024-02002-7
Abstrakt: Objectives: To evaluate the predictive value of standardized uptake value (SUV) in both primary tumors and axillary lymph nodes (ALNs) using FDG PET/CT for lymph node metastasis in breast cancer patients, and to assess the influence of molecular subtypes on this predictive performance.
Methods: This retrospective study included 287 patients with invasive ductal carcinoma (IDC) who underwent FDG PET/CT prior to surgery between September 2016 and December 2019. The maximum standardized uptake value (SUV max ) of primary tumors (SUV-B) and ALNs (SUV-LN) were analyzed. Molecular subtypes were classified as hormone receptor-positive, HER2-positive, and triple-negative breast cancer (TNBC). Receiver operating characteristic (ROC) curve analysis was performed to assess and compare the diagnostic performance of SUV-B and SUV-LN for predicting ALN metastasis.
Results: Among the 287 patients, 62 (21.6%) had confirmed ALN metastasis. The median SUV-LN was significantly higher in patients with metastasis compared to those without metastasis (1.5 vs. 0.9; P < 0.001). SUV-LN demonstrated good discriminative performance for ALN metastasis (AUC: 0.796), whereas SUV-B did not show significant predictive value (AUC: 0.536). The SUV_LN demonstrated significantly lower predictive performance for ALN metastasis in the hormone-positive group (AUC: 0.796) compared to the excellent discriminative performance in the HER2-positive (AUC: 0.923, P = 0.018) and TNBC (AUC: 0.940, P = 0.004) groups. Hormone receptor-positive tumors also exhibited lower FDG uptake in metastatic lymph nodes compared to HER2-positive and TNBC subtypes (P = 0.031).
Conclusion: FDG PET/CT SUV-LN effectively predicts ALN metastasis in HER2-positive and TNBC subtypes. Hormone receptor-positive breast cancers show lower FDG uptake in metastatic ALNs, reducing diagnostic accuracy. This finding may aid in selecting the most appropriate diagnostic modality based on tumor characteristics in the era of personalized medicine.
Competing Interests: Declarations. Conflict of interest: The authors have no conflicts to disclose. Ethical approval: This study was approved by the Institutional Review Board (IRB) and Ethic Committee of the Soonchunhyang University Seoul Hospital (#2024–06-011). Written informed consent was waived by the IRB of the Soonchunhyang University Seoul Hospital due to retrospective design.
(© 2024. The Author(s) under exclusive licence to The Japanese Society of Nuclear Medicine.)
Databáze: MEDLINE
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