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

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Annals of Nuclear Medicine Pub Date : 2024-12-02 DOI:10.1007/s12149-024-02002-7

Chae Hong Lim, Jun-Hee Lee, Jihyoun Lee, Soo Bin Park

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引用次数: 0

Abstract

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.

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18f -氟脱氧葡萄糖摄取对可手术乳腺癌腋窝淋巴结转移的预测价值：分子亚型的影响

目的：评价FDG PET/CT标准化摄取值（SUV）对乳腺癌原发肿瘤和腋窝淋巴结（ALNs）转移的预测价值，并评估分子亚型对这一预测性能的影响。方法：回顾性研究纳入2016年9月至2019年12月期间287例术前行FDG PET/CT检查的浸润性导管癌（IDC）患者。分析原发肿瘤（SUV-B）和aln （SUV-LN）的最大标准化摄取值（SUVmax）。分子亚型分为激素受体阳性、her2阳性和三阴性乳腺癌（TNBC）。采用受试者工作特征（ROC）曲线分析来评估和比较SUV-B和SUV-LN预测ALN转移的诊断性能。结果：287例患者中，62例（21.6%）确诊ALN转移。有转移的患者的中位SUV-LN明显高于无转移的患者(1.5 vs 0.9；结论：FDG PET/CT SUV-LN可有效预测her2阳性和TNBC亚型的ALN转移。激素受体阳性的乳腺癌在转移性aln中显示较低的FDG摄取，降低了诊断的准确性。这一发现可能有助于在个性化医疗时代根据肿瘤特征选择最合适的诊断方式。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Nuclear Medicine 医学-核医学

CiteScore

4.90

自引率

7.70%

发文量

111

审稿时长

4-8 weeks

期刊介绍： Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine. The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.