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Comparison of standardized uptake value of 18F-FDG-PET-CT with 21-gene recurrence score in estrogen receptor-positive, HER2-negative breast cancer

 Sung Gwe Ahn  ;  Jae-Hoon Lee  ;  Hak Woo Lee  ;  Tae Joo Jeon  ;  Young Hoon Ryu  ;  Kun Min Kim  ;  Joohyuk Sohn  ;  Mijin Yun  ;  Seung Ah Lee  ;  Joon Jeong  ;  Seung Il Kim 
 PLoS One, Vol.12(4) : e0175048, 2017 
Journal Title
 PLoS One 
Issue Date
Adult ; Aged ; Breast Neoplasms/diagnostic imaging* ; Breast Neoplasms/drug therapy ; Breast Neoplasms/genetics* ; Chemotherapy, Adjuvant ; Female ; Fluorodeoxyglucose F18/pharmacokinetics* ; Gene Expression Profiling* ; Gene Expression Regulation, Neoplastic ; Genetic Predisposition to Disease/genetics* ; Humans ; Logistic Models ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local ; Positron Emission Tomography Computed Tomography/methods ; Positron Emission Tomography Computed Tomography/standards* ; Prognosis ; Receptor, ErbB-2/metabolism ; Receptors, Estrogen/metabolism* ; Receptors, Progesterone/genetics ; Reference Standards ; Reference Values ; Reverse Transcriptase Polymerase Chain Reaction
BACKGROUND: We investigated the relationship between 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG-PET-CT) standardized uptake value (SUV) and 21-gene recurrence score (RS) in estrogen receptor (ER)-positive/HER2-negative breast cancer. MATERIALS AND METHODS: One hundred sixty-seven patients were identified among those who underwent preoperative 18F-FDG-PET-CT and had RS. Maximum SUV was obtained from 18F-FDG-PET-CT; the cut-off point was 4. RESULTS: The continuous RS and SUV correlated positively (Pearson's R = 0.555; P < 0.001). An inverse correlation was found between progesterone receptor (PR) expression by reverse transcriptase-polymerase chain reaction, and SUV (Pearson's R = -0.408; P < 0.001). Good agreement between dichotomized RS (<26 vs. ≥26) and SUV (<4 vs. ≥4) was observed in 137 of 167 patients (82.0%; 95% confidence interval [CI], 76.2-87.9). Among patients with low SUV, 114 of 115 (99.1% [95% CI, 97.4-100.0]) had tumors with lower RS (<26). Although 23 of 52 women (44.2% [95% CI, 30.7-57.7]) with high SUV had higher RS (≥26), all 13 women with high RS (≥31) had high-SUV tumors. Most cases with disagreements between SUV and RS (n = 30) were classified as high SUV/lower RS (n = 29). The discordant group had higher grade or elevated Ki67 expression (≥20%) compared with the low SUV/lower RS group (n = 109), but higher PR expression compared with the high SUV/higher RS group (n = 23). Multiple logistic regression analysis showed that high SUV were associated with higher RS (≥26). CONCLUSIONS: SUV, as a biologic parameter represented using a continuous variable, was found to associate with RS in ER-positive, HER2-negative breast cancer. Further studies may reveal the biology underlying the discordance between the markers.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
Yonsei Authors
김건민(Kim, Gun Min) ORCID logo https://orcid.org/0000-0001-9167-8682
김승일(Kim, Seung Il)
손주혁(Sohn, Joo Hyuk) ORCID logo https://orcid.org/0000-0002-2303-2764
안성귀(Ahn, Sung Gwe) ORCID logo https://orcid.org/0000-0002-8778-9686
유영훈(Ryu, Young Hoon) ORCID logo https://orcid.org/0000-0002-9000-5563
윤미진(Yun, Mi Jin) ORCID logo https://orcid.org/0000-0002-1712-163X
이재훈(Lee, Jae Hoon) ORCID logo https://orcid.org/0000-0002-9898-9886
이학우(Lee, Hak Woo)
전태주(Jeon, Tae Joo) ORCID logo https://orcid.org/0000-0002-7574-6734
정준(Jeong, Joon) ORCID logo https://orcid.org/0000-0003-0397-0005
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