Tumor metabolism and perfusion ratio assessed by 18F-FDG PET/CT and DCE-MRI in breast cancer patients: Correlation with tumor subtype and histologic prognostic factors.

Abstract

OBJECTIVE: Our purpose was to evaluate whether breast cancer with high metabolic-perfusion ratio would be associated with poor histopathologic prognostic factors and whether triple negative breast cancer (TNBC) would show high metabolic-perfusion ratio compared to non-triple negative breast cancer (non-TNBC).

METHODS: From March 2011 to November 2011, 67 females with invasive ductal carcinoma of breast who underwent both MRI and 18F-FDG PET/CT were included. Perfusion parameters including Ktrans, Kep and Ve were acquired from Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Metabolic parameters including the standardized uptake value (SUV) and volumetric metabolic parameters including metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were obtained from F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT).

RESULTS: In non-TNBC, SUVmax was significantly correlated with Kep (ρ=0.298, p=0.036) and Ve (ρ=-0.286, p=0.044). In TNBC, there was no significant correlation between all perfusion and metabolic parameters. Compared to non-TNBC, higher SUVmax (10.2 vs 5.3, p<0.001), higher SUVmax/Ktrans (56.02 vs 20.3, p<0.001), higher MTV50/Ktrans (7.8 vs 16.54, p<0.001), higher TLG50/Ktrans (36.49 vs 12.3, p<0.001), higher TLG50/Ve (91.34 vs 27.1 p=0.022) were significantly correlated with TNBC. Lower Ktrans (0.17 vs 0.29, p=0.017) and lower Ve (0.29 vs 0.41, p=0.011) were also significantly associated TNBC.

CONCLUSION: While several perfusion parameters and metabolic parameters were correlated in non-TNBC, they were not correlated in TNBC. TNBC showed higher metabolic-perfusion ratios compared to non-TNBC.