TY - JOUR
T1 - Comparative study of the value of dual tracer PET/CT in evaluating breast cancer
AU - Tateishi, Ukihide
AU - Terauchi, Takashi
AU - Akashi-Tanaka, Sadako
AU - Kinoshita, Takayuki
AU - Kano, Daisuke
AU - Daisaki, Hiromitsu
AU - Murano, Takeshi
AU - Tsuda, Hitoshi
AU - Macapinlac, Homer A.
PY - 2012/9
Y1 - 2012/9
N2 - 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 11C-choline and 2-[ 18F]fluoro-2-deoxy-d-glucose ( 18F-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 18F-FDG PET/CT and 11C-choline PET/CT. However, 18F-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 11C-choline PET/CT. In conclusion, 11C-choline may improve tumor delineation and reflect tumor aggressiveness on PET/CT in patients with breast cancer.
AB - 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 11C-choline and 2-[ 18F]fluoro-2-deoxy-d-glucose ( 18F-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 18F-FDG PET/CT and 11C-choline PET/CT. However, 18F-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 11C-choline PET/CT. In conclusion, 11C-choline may improve tumor delineation and reflect tumor aggressiveness on PET/CT in patients with breast cancer.
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U2 - 10.1111/j.1349-7006.2012.02348.x
DO - 10.1111/j.1349-7006.2012.02348.x
M3 - Article
C2 - 22632272
AN - SCOPUS:84865726052
SN - 1347-9032
VL - 103
SP - 1701
EP - 1707
JO - Cancer science
JF - Cancer science
IS - 9
ER -