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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.

Abstract


Aims:

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.

Results:

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.

 Conclusion:

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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Keywords


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

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References


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