Correlations between dual-phase 18F-FDG uptake and clinicopathologic and biological markers in predicting the aggressiveness of breast cancer

Objective: To assess the correlations between dual-phase fluorine-18 uorodeoxyglucose (F-18-FDG) uptake and clinicopathological and immunohistochemical prognostic factors in patients with surgically resected breast cancer stage I-III. Subjects and Methods: We retrospectively analyzed the cases of 105 patients. We calculated the maximum standardized uptake value (SUVmax) at 85min (SUV1), SUVmax at 125min (SUV2) and the retention index [RI]. Spearman's rank correlation test, the Kruskal-Wallis test and receiver operating 18 characteristic (ROC) analysis were performed to assess the association between F-18-FDG uptake and the clinicopathological and immunohistochemical factors: glucose transporter-1 (Glut-1), estrogen receptor alpha (ER alpha), ER beta, progesterone receptor (PR), human epidermal growth factor 2 (Her2), mammalian target of rapamycin (mTOR), and P70S6kinase (P70S6). Results: The SUV1 and SUV2 values were correlated with Glut-1, pathological tumor size, ERa negativity, and pathological stage (all P values were <0.05), but not with mTOR, P70S6, ER beta, PR, Her2 or other factors. The SUV1 and SUV2 in the triple negative subtype were significantly higher than those of the hormone receptor-positive subtype (P<0.05). The RI was associated with pathological tumor size alone. In the ROC analysis of Glut-1, the areas under the curve for SUV1 and SUV2 were significantly larger than for RI (SUV1, P=0.032, SUV2, P=0.022). Conclusion: Glucose transporter-1, estrogen 18 receptor alpha negativity and nuclear grade might affect the high F-18-FDG uptake in breast cancer. The SUVmax might be more useful than the RI for predicting the Glut-1 expression and the aggressiveness of breast cancer.