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Dual tracer 18F FDG-FCH PET-CT markers and Gene expression profiling in the evaluation of an aggressive breast carcinoma

Fathinul Fikri A.S, Razinul Aiman FF, Shazreen S, Malini K, Shahrun Niza S.



To determine the superiority of 18F-FDG-FCH PET-CT markers and Gene expression profiling in detecting and predicting aggressive breast carcinoma. 

Materials and Methods:

17 prospective subjects with primary or recurrent breast carcinoma underwent dual tracers PET-CT imaging utilising 18F-FCH and 18F-FDH prior to biopsy. All subjects had Birads 4/5 breast lesions on mammogram and were dichotomised into malignant and benign groups and HER-negative(HER-ve) and HER-positive(HER+ve). Direct qualitative and semiquantative analysis (SUVmax) on PET, histology and phenotypes were analysed as variables markers using biopsy findings as a gold standard.


Fourteen patients with mean age of 52.82±10.71 years had malignant disease (14/17; 82.35%) with thirteen (9/17, 52.9%) with HER–ve phenotype. Mean FDG SUVmax (g/dl) and FCH SUVmax (g/dl) were 1.49±1.40 and 1.15±1.42 respectively. On per patient basis, the sensitivity and specificity for FDG PET-CT (8/8; 100%) and (3/4; 75%) respectively as compared to FCH PET-CT (3/3; 100%) and (3/3; 100%). There was a significant different between FCH SUVmax of the HER-ve and HER+ve group (1.99±1.52vs 0.20±0.22; p<0.05). FDG SUVmax revealed a significant different between the HER-ve and HER+ve groups (2.09±1.50g/dl vs 0.66 ± 1.07g/dl).  The malignant group has higher FDG -PET SUVmax and FCH PET SUV as compared to the benign group (1.76±1.40 g/dl vs 0.24±0.21g/dl; p<0.05) and (1.36±1.48g/dl vs 0.13±0.11g/dl; p<0.05) respectively.


Higher SUVmax of 18F-FDG-FCH PET and HER-ve phenotypes are potentially strong markers for an aggressive breast cancer which are important in stratifying patients undergoing endocrine treatment. 

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FDG PET-CT, FCH PET-CT, HER-ve, HER+ve, breast cancer

Full Text:



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