유방암에서 $^{18}F$-FDG PET/CT의 pSUV와 병리학적 진단과의 연관성

Relationship Between pSUV of $^{18}F$-FDG PET/CT and Pathological Diagnosis in Breast Cancer

  • 김미영 (단국대학교병원 영상의학과)
  • Kim, Mi-Young (Department of Diagnostic Radiology, Dankook University Hospital)
  • 투고 : 2013.10.01
  • 심사 : 2013.12.05
  • 발행 : 2013.12.31

초록

이 연구는 $^{18}F$-FDG PET/CT의 SUV에 영향을 미치는 병리학적 요인들을 알아보는 것이다. 2012년 09월부터 2013년 07월까지 한 대학병원에서 유방암으로 진단되어 $^{18}F$-FDG PET/CT를 시행하고 외과적 수술을 받은 39명을 대상으로 하여, pSUV와 종양크기, 조직학적 등급, 핵등급, 호르몬 수용체와 C-erbB-2의 발현 상태 간의 관계를 분석하였다. 연구결과 종양의 크기가 클수록 pSUV가 높은 것으로 나타났으나 크기에 따른 통계적 유의성은 없는 것으로 나타났다. 조직학적 등급은 고등급의 pSUV가 더 높은 것으로 나타났으며 유의한 양의 상관관계가 있었다.ER( estrogen receptor), PR( progesteron receptor )은 양성에 비해 음성의 pSUV가 더 높았으며 유의한 음의 상관관계가 있었다. 유방암에서 $^{18}F$-FDG PET/CT의 pSUV는 조직학적 등급, ER과 PR과 상관관계가 있었다. 따라서 유방암 초기 진단에 있어 $^{18}F$-FDG PET/CT를 이용한다면 조직검사나 수술을 통해 얻을 수 있는 조직학적 정보를 수술 전에 예측하여 치료방향에 도움을 줄 수 있을 것으로 생각된다.

The purpose of this study was to evaluate the Pathological Diagnosis associated with pSUV uptake of $^{18}F$-FDG PET/CT. We had enrolled 39 women that underwent $^{18}F$-FDG PET/CT before operative. We evaluated whether there was correlation between the pSUV of $^{18}F$-FDG PET/CT and prognostic factors. As a results, pSUV level increase according to tumor size but pSUV had no significant association with tumor size. pSUV of high histologic grade was higher than low histologic grade, and pSUV showed positive correlations with histologic grade. The ER and PR showed significant negative correlations with the pSUV of $^{18}F$-FDG PET/CT. Therefore, our results demonstrated that an correlation exists between pSUV and prognostic factors such as histologic grade, ER and PR.

키워드

참고문헌

  1. Seo HI, Bae YT, Han KT, Kim SJ, Park DY: Clinicopathological Characteristics in Invasive Ductal Breast Cancer with Low FDG Uptake in $^{18}F$-FDG PET/CT. J Breast Cancer. 13(1), 83-89, 2010 https://doi.org/10.4048/jbc.2010.13.1.83
  2. Jadvar H, Alavi A, Gambhir SS: 18F-FDG Uptake in Lung, Breast, and Colon Cancers: Molecular Biology Correlates and Disease Characterization. J Nucl Med. 50, 1820-1827, 2009 https://doi.org/10.2967/jnumed.108.054098
  3. Avril N, Menzel M, Dose J, Schelling M, Weber W, Janicke F, et al: Glucose Metabolism of Breast Cancer Assessed by 18F-FDG PET: Histologic and Immunohistochemical Tissue Analysis. J Nucl Med. 42, 9-16, 2001
  4. Buck AK, Schirrmeister H, Mattfeldt T, Reske SN: Biological Characterization of Breast Cancer by Means of PET. Eur J Nucl Med Mol Imaging. 31(1), 80-87, 2004 https://doi.org/10.1007/s00259-004-1529-6
  5. Kumar R, Chauhan A, Zhuang H, Chandra P, Schnall M, Alavi A: Clinicopathologic Factors Associated with False Negative FDG-PET in Primary Breast Cancer. Breast Cancer Res Treat. 98, 267-274, 2006 https://doi.org/10.1007/s10549-006-9159-2
  6. Walter C, Scheidhauer K, Scharl A, Goering UJ, Theissen P, Kugel H, et al: Clinical and Diagnostic Value of Preoperative MR Mammography and FDG-PET in Suspicious Breast Lesions. Eur Radiol. 13, 1651-1656, 2003 https://doi.org/10.1007/s00330-002-1816-1
  7. Rose C, Dose J, Avril N: Positron Emission Tomography for the Diagnosis of Breast Cancer. Nucl Med Commun. Vol.23, pp.613-618, 2002 https://doi.org/10.1097/00006231-200207000-00004
  8. Avril N, Dose J, Janicke F, Bense S, Ziegler S, Lauvenvacher C, et al: Metabolic Characterization of Breast Tumors with Positron Emission Tomography Using F-18 Fluorodeoxyglucose. J Clin Oncol. 14, 1848-1857, 1996 https://doi.org/10.1200/JCO.1996.14.6.1848
  9. Adler LP, Crowe JP, al-Kaisi NK, Sunshine JL: Evaluation of Breast Masses and Axillary Lymph Nodes with [F-18]2-deoxy-2-fluoro-D-glucose PET. Radiology. 187, 743-750, 1993 https://doi.org/10.1148/radiology.187.3.8497624
  10. Hanahan D, Weinberg RA: The Hallmarks of Cancer. Cell. 100, 57-70, 2000 https://doi.org/10.1016/S0092-8674(00)81683-9
  11. Kostakoglu L, Goldsmith S: Fluorodeoxyglucose Positron Emission Tomography in the Staging and Follow-up of Lymphoma: Is It Time to Shift Gears?. Eur J Nucl Med. 27, 1564-1578, 2000 https://doi.org/10.1007/s002590000340
  12. Mac Manus M, Hicks R, Ball D, Kalff V, Matthews JP, Salminen E, et al: F-18 Fluorodeoxyglucose Positron Emission Tomography Staging in Radical Radiotherapy Candidates with Nonsmall Cell Lung Carcinoma: Powerful Correlation with Survival and High Impact on Treatment. Cancer. 92, 886-895, 2001 https://doi.org/10.1002/1097-0142(20010815)92:4<886::AID-CNCR1397>3.0.CO;2-V
  13. Hung G, Shiau Y, Tsai S, Chao T, Ho Y, Kao C: Value of 18F-Fluoro-2-deoxyglucose Positron Emission Tomography in the Evaluation of Recurrent Colorectal Cancer. Anticancer Res. 21, 1375-1378, 2001
  14. Oshida M, Uno K, Suzuki M, Nagashima T, Hashimoto H, Yagata H, et al: Predicting the Prognoses of Breast Carcinoma Patients with Positron Emission Tomography Using 2-deoxy- 2-fluoro[$^{18}F$]-D-glucose. Cancer. 82, 2227- 2234, 1998 https://doi.org/10.1002/(SICI)1097-0142(19980601)82:11<2227::AID-CNCR18>3.0.CO;2-W
  15. Sorlie T: Molecular Portraits of Breast Cancer: Tumour Subtypes as Disease Entities. Eur J Cancer. 40, 2667-2675, 2004 https://doi.org/10.1016/j.ejca.2004.08.021
  16. Bae SY, Lee EH, Park JM, Kwak JJ: 18F-Fluorodeoxyglucose Positron Emission Tomography/CT Scan Findings for Ductal Carcinomas of Breast: Association of Standardized Uptake Value and Histological Findings. J Korean Soc Radiol. 66(2), 169-175, 2012 https://doi.org/10.3348/jksr.2012.66.2.169
  17. Jeong SH, Lee EH, Park JM, Lee HK, Yi BH, Choi N: Factors Affecting 18F-Fluorodeoxyglucose (FDG) Uptake in Breast Cancer. J Korean Soc Radiol. 63, 87-292, 2010
  18. Groheux D, Moretti JL, Basillet G, Espie M, Giacchetti S, Hindie E: Effects of 18F-FDG PET/CT Imaging in Patients with Clinical Stage II and III Breast Cancer. Int J Radiat Cncol Biol Phys. 71, 2695-704, 2008
  19. Gil-Rendo A, Martinez-Regueira F, Zomoza G, Garcia-Velloso MJ, Beorlegui C, Rodriguez- Spiteri N, et al: Association Between 18FFluorodeoxyglucose Uptake and Prognostic Parameters in Breast Cancer. Br J Surg. 96, 166-170, 2009 https://doi.org/10.1002/bjs.6459
  20. Flope AL, Lyles RH, Sprouse JT, Conrad EU 3rd, Eary JF: [18-F]fluorodeoxyglucose Positron Emission Tomography as a Predictor of Pathologic Grade and Other Prognostic Variables in Bone and Soft Tissue Sarcoma. Clin Cancer Res. 6, 1279-1287, 2000
  21. Basu S, Chen W, Tchou J, Mavi A, Cermik T, Czerniecki B, et al: Comparison of Triple-negative and Estrogen Receptor-positive/Progesterone Receptor-positive/HER2-negative Breast Carcinoma Using Quantitative Fluorine-18 Fluorodeoxyglucose/ Positron Emission Tomography Imaging Parameters: A Potentially Useful Method for Disease Characterization. Cancer. 112, 995-1000, 2008 https://doi.org/10.1002/cncr.23226
  22. Mavi A, Cermilk TF, Urhan M, Puskulcu H, Basu S, Yu JQ, et al: The Effects of Estrogen, Progesterone, and C-erbB-2 Receptor States on 18F-FDG Uptake of Primary Breast Cancer Lesion. J Nucl Med. 48, 1266-1272, 2007 https://doi.org/10.2967/jnumed.106.037440