Total Lesion Glycolysis on 18F-FDG PET/CT of Women with Non-Locally Advanced Breast Cancer: Does it Correlate with CT Density of the Lesion?

Öz

Objective: Breast cancer (BC) is the second most frequent malignancy in women. Fluorine-18-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/computed tomography (CT) has become a major diagnostic tool for staging of the disease and predicting the prognosis. We aimed to evaluate the correlation between main quantitative ¹⁸F-FDG PET/CT parameters- primarily TLG (total lesion glycolysis), and CT density measurements as Hounsfield Unit (HU) of the primary BC masses in non-locally advanced BC (non-LABC) patients. And also we aimed to see whether there is a correlation between the volume and HU measurements of BC masses in non-LABC patients.

Methods: In this retrospective study, we included 17 women with unilateral non-LABC having a mean age of 54.1±10.3 years who underwent ¹⁸F-FDG PET/CT before any treatment between 2016−2017.  The mean volume, HU, maximum standardized uptake value (SUVmax) and TLG of the primary BC masses with their standard deviations and 95% confidence intervals (CI)s were calculated. Of the BC masses, the correlations between their mean TLG and mean HU, their mean SUVmax and mean HU, their mean volume and mean HU were statistically calculated.

Results: The mean volume and HU of BC masses were 4.6±3.9 mL (95% CI: 2.6−6.6) and 42.5±4.1 HU (95% CI: 40.3−44.6), respectively. The mean SUVmax and TLG of BC masses were 6.4±5.6 g/mL (95% CI: 3.5−9.3) and 22.1±14.2 g/mLxmL (95% CI: 14.7−29.4), respectively. Of the BC masses, the correlations between their mean TLG and mean HU  (r=-0.443, P=0.075), besides their  mean SUVmax and mean HU (r=-0.368, P=0.146) were not statistically significant. The correlation between the mean volume and the mean HU of BC masses was also statistically insignificant (r=-0.214, P=0.410).

Conclusion: In women with non-LABC, ¹⁸F-FDG PET/CT is a useful and reliable tool for obtaining the TLG of primary BC masses presenting with various CT densities. 

Anahtar Kelimeler

• Fluorodeoxyglucose F18,Positron Emission Tomography Computed Tomography,Carcinoma,Ductal,Breast,Glycolysis

Lokal Olarak İlerlememiş Meme Kanserli Kadınların 18F-FDG PET/BT Tetkiklerinde Toplam Lezyon Glikolizi: Lezyonun BT Dansitesi ile Bağıntılı mı?

Öz

Amaç: Meme kanseri kadınlardaki ikinci en sık malign tümördür. Flor-18-florodeoksiglukoz pozitron emisyon tomografisi/bilgisayarlı tomografi (18F-FDG PET/BT), hastalığın evrelemesi ve prognozun belirlenmesi için başlıca tanı aracı haline gelmiştir. Lokal olarak ilerlememiş meme kanseri olgularının primer kitlelerinde, başta toplam lezyon glikolizi (TLG) olmak üzere ana nicel 18F-FDG PET/BT değişkenleri ve Hounsfield ünitesi (HU) şeklinde BT dansite ölçümleri arasındaki bağıntıyı değerlendirmeyi ve ayrıca, bu kitlelerin hacimleri ile  HU ölçümleri arasında bir bağıntı olup olmadığını görmeyi amaçladık.

Gereç ve Yöntem: Bu retrospektif çalışmaya, 2016−2017 yıllarında tedavi öncesi 18F-FDG PET/BT tetkiki yapılan, yaş ortalaması 54.1±10.3 yıl olan ve tek taraflı, lokal olarak ilerlememiş meme kanseri bulunan 17 kadın olgu alınmıştır. Primer meme kanseri kitlelerinin hacim,  HU, en yüksek standart tutulum değeri (SUVmaks) ve TLG ortalamaları, standart sapmalar ve %95 güven aralığı (GA) ile birlikte hesaplandı. Bu kitlelerin TLG ve HU, SUVmaks ve HU, hacim ve HU değerleri arasındaki bağıntı istatistiksel olarak hesaplandı.

Bulgular: Meme kanseri kitlelelerinin ortalama hacmi ve HU değeri sırasıyla 4.6±3.9 mL (%95 GA: 2.6−6.6) ve  42.5±4.1 HU (%95 GA: 40.3−44.6) bulundu. Bu kitlelerin ortalama SUVmaks ve TLG’si sırasıyla 6.4±5.6 g/mL (%95 GA: 3.5−9.3) ve  22.1±14.2 g/mLxmL (%95 GA: 14.7−29.4) bulundu. Meme kanseri kitlelerinin ortalama TLG’si ile HU değeri arasında (r=-0.443, P=0.075) ve ortalama SUVmaks’ı ile HU değeri arasında (r=-0.368, P=0.146) istatistiksel olarak anlamlı bağıntı saptanmadı. Bu kitlelerin ortalama hacmi ve HU değeri arasındaki bağıntı da istatistiksel olarak anlamlı bulunmadı (r=-0.214, P=0.410).

Sonuç: 18F-FDG PET/BT lokal olarak ilerlememiş meme kanserli kadınlarda, değişik BT dansiteleri ile kendini gösteren primer meme kanseri kitlelerinin TLG’lerini hesaplamada  yararlı ve güvenilir bir araçtır.  

Anahtar Kelimeler

• Fluorodeoksiglukoz F18,Pozitron Emisyon Tomografi bilgisayarlı Tomografi,Karsinoma,Duktal,Meme,Glikoliz

Kaynakça

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