TY - JOUR
T1 - Diagnostic performance of [18 f]fdg pet in staging grade 1–2, estrogen receptor positive breast cancer
AU - Iqbal, Ramsha
AU - Mammatas, Lemonitsa H.
AU - Aras, Tuba
AU - Vogel, Wouter V.
AU - van de Brug, Tim
AU - Oprea-Lager, Daniela E.
AU - Verheul, Henk M. W.
AU - Hoekstra, Otto S.
AU - Boellaard, Ronald
AU - Menke-van der Houven van Oordt, Catharina W.
N1 - Funding Information: Funding: This research was financially supported by the Cancer Center Amsterdam. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Positron emission tomography using [ 18 F]fluorodeoxyglucose (FDG PET) potentially underperforms for staging of patients with grade 1–2 estrogen receptor positive (ER+) breast cancer. The aim of this study was to retrospectively investigate the diagnostic accuracy of FDG PET in this patient population. Suspect tumor lesions detected on conventional imaging and FDG PET were confirmed with pathology or follow up. PET-positive lesions were (semi)quantified with standardized uptake values (SUV) and these were correlated with various pathological features, including the histological subtype. Pre-operative imaging detected 155 pathologically verified lesions (in 74 patients). A total of 115/155 (74.2%) lesions identified on FDG PET were classified as true positive, i.e., malignant (in 67 patients) and 17/155 (10.8%) lesions as false positive, i.e., benign (in 9 patients); 7/155 (4.5%) as false negative (in 7 patients) and 16/155 (10.3%) as true negative (in 14 patients). FDG PET incorrectly staged 16/70 (22.9%) patients. The FDG uptake correlated with histological subtype, showing higher uptake in ductal carcinoma, compared to lobular carcinoma (p < 0.05). Conclusion: Within this study, FDG PET inadequately staged 22.9% of grade 1–2, ER + BC cases. Incorrect staging can lead to inappropriate treatment choices, potentially affecting survival and quality of life. Prospective studies investigating novel radiotracers are urgently needed.
AB - Positron emission tomography using [ 18 F]fluorodeoxyglucose (FDG PET) potentially underperforms for staging of patients with grade 1–2 estrogen receptor positive (ER+) breast cancer. The aim of this study was to retrospectively investigate the diagnostic accuracy of FDG PET in this patient population. Suspect tumor lesions detected on conventional imaging and FDG PET were confirmed with pathology or follow up. PET-positive lesions were (semi)quantified with standardized uptake values (SUV) and these were correlated with various pathological features, including the histological subtype. Pre-operative imaging detected 155 pathologically verified lesions (in 74 patients). A total of 115/155 (74.2%) lesions identified on FDG PET were classified as true positive, i.e., malignant (in 67 patients) and 17/155 (10.8%) lesions as false positive, i.e., benign (in 9 patients); 7/155 (4.5%) as false negative (in 7 patients) and 16/155 (10.3%) as true negative (in 14 patients). FDG PET incorrectly staged 16/70 (22.9%) patients. The FDG uptake correlated with histological subtype, showing higher uptake in ductal carcinoma, compared to lobular carcinoma (p < 0.05). Conclusion: Within this study, FDG PET inadequately staged 22.9% of grade 1–2, ER + BC cases. Incorrect staging can lead to inappropriate treatment choices, potentially affecting survival and quality of life. Prospective studies investigating novel radiotracers are urgently needed.
KW - Breast cancer
KW - Estrogen receptor
KW - Positron emission tomography (PET)
KW - Staging
KW - [ F]FDG
UR - http://www.scopus.com/inward/record.url?scp=85117597615&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/diagnostics11111954
DO - https://doi.org/10.3390/diagnostics11111954
M3 - Article
C2 - 34829301
SN - 2075-4418
VL - 11
JO - Diagnostics (Basel, Switzerland)
JF - Diagnostics (Basel, Switzerland)
IS - 11
M1 - 1954
ER -