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. 2024;12(1):11-20.
doi: 10.22038/AOJNMB.2023.70534.1493.

Comparison between 18F-FDG PET/CT and diffusion-weighted imaging in detection of invasive ductal breast carcinoma

Aynur Ozen  1 , Tarik Sayin  2 , Ozan Kandemir  3 , Ozgul Ekmekcioglu  4 , Serdar Altınay  5 , Eylem Bastug  1 , Ali Muhammedoglu  6 , Atilla Celik  7 , Ramazan Albayrak  8
Affiliations

Comparison between 18F-FDG PET/CT and diffusion-weighted imaging in detection of invasive ductal breast carcinoma

Aynur Ozen et al. Asia Ocean J Nucl Med Biol. 2024.

Abstract

Objectives: Breast carcinoma is the most common type of cancer in females. This study aims to compare fluorine-18-fluorodeoxyglucose (18F-FDG) uptake pattern and apparent diffusion coefficient (ADC) value for the detection of the primary tumour and axillary metastases of invasive ductal breast carcinoma.

Methods: This study included 40 breast carcinoma lesions taken from 39 patients. After staging by positron emission tomography-computed tomography (PET/CT) and diffusion-weighted magnetic resonance imaging (MRI), breast surgery with axillary lymph node dissection or sentinel lymph node biopsy was performed.

Results: Primary lesion detection rate for PET/CT and diffusion-weighted MRI was high with 39 of 40 lesions (97.5%). The sensitivity and specificity for the detection of metastatic lymph nodes in axilla were 40.9%, 88.9%, with 18F-FDG PET/CT scans and 40.9%, 83.3%, for dw-MRI, respectively. No significant correlation was detected between ADC and SUVmax or SUVmax ratios. Estrogen receptor (p=0.007) and progesterone receptor (p=0.036) positive patients had lower ADC values. Tumour SUVmax was lower in T1 than T2 tumour size (p=0.027) and progesterone receptor-positive patients (p=0.029). Tumour/background SUVmax was lower in progesterone receptor-positive patients (p=0.004). Tumour/liver SUVmax was higher in grade III patients (p=0.035) and progesterone receptor negative status (p=0.043).

Conclusions: This study confirmed the high detection rate of breast carcinoma in both modalities. They have same sensitivity for the detection of axillary lymph node metastases, whereas the PET/CT scan had higher specificity. Furthermore, ADC, SUVmax and SUVmax ratios showed some statistical significance among the patient groups according to different pathological parameters.

Keywords: Apparent diffusion coefficient Diffusion magnetic resonance imaging; Breast carcinoma; Positron emission tomography; Standardized maximal uptake.

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Conflict of interest statement

The authors declare that there is no conflict of interest, financial or otherwise.

Figures

Figure 1
Figure 1
A 57 years old woman with IDBC of the left breast. On immunohistochemical study, ER and PR status were negative and Her2/neu was positive. Axial PET (a) and CT images (b) showed 18F-FDG uptake in the left breast signified by cursor at primary lesion with measured SUVmax, 4.1. Axillary metastases with 8.9 SUVmax were seen PET scan (c) and CT (d) images (arrow). The MRI lesion in the left breast (white arrow) had a hypointense signal with an irregular border at axial T1 (e) and T2 (f) weighted images. The lesion in dynamic sequences showed an increasingly homogenous contrast-enhanced mass (g), and in the short-time inversion recovery (STIR) sequences showed isosignal intensity mass (h). Axillary metastatic lymphadenopathy with decreased (or not) fatty hilus (gray arrow) was seen as iso-hypointense signal intensity in T1 and T2 weighted images with diffuse contrast-enhanced patterns at dynamic sequences. The calculated mean ADC value for primary lesion and axillary metastasis were 1.22×10-3 mm2/s and 0.95×10-3 mm2/s, respectively
Figure 2
Figure 2
(a) Transaxial PET/CT images in supine position, (b) images at prone position obtained shortly after supine position images for accurate localization of primary tumour and (c) ADC map in diffusion-weighted imaging display, in a 40 year old woman with IDBC and 2.5 cm tumour size, grade 3, ER-PR positive, 1+ Her2/neu status in the right breast. ROIs are shown on (a) and (b) for measuring SUVmax, and on (c) for measuring the mean ADC value
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References

    1. Rim A, Chellman-Jeffers M. Trends in breast cancer screening and diagnosis. Cleve Clin J Med. 2008;75:2–9. - PubMed
    1. Van Goethem M, Schelfout K, Kersschot E, Colpaert C, Verslegers I, Biltijes W, et al. MR mammography is useful in the preoperative locoregional staging of breast carcinomas with extensive intraductal component. Eur J Radiol. 2007;62(2):273–82. - PubMed
    1. Biglia N, Mariani L, Sgro L, Mininanni P, Moggio G, Sismondi P. Increased incidence of lobular breast cancer in women treated with hormone replacement therapy: implications for diagnosis, surgical and medical treatment. Endocr Relat Cancer. 2007;14(3):549–67. - PubMed
    1. Moon M, Cornfeld D, Weinreb J. Dynamic contrast-enhanced breast MR imaging. Magn Reson Imaging Clin N Am. 2009;17(2):351–362. - PubMed
    1. Tamaki Y, Akashi-Tanaka S, Ishida T, Uematsu T, Sawai Y, Kusama M, et al. 3D imaging of intraductal spread of breast cancer and its clinical application for navigation surgery. Breast Cancer. 2002;9(4):289–95. - PubMed

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