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BMC Medical Imaging
Published in: BMC Medical Imaging 1/2018

Open Access 01-12-2018 | Research article

Quantification of FDG-PET/CT with delayed imaging in patients with newly diagnosed recurrent breast cancer

Authors: Christina Baun, Kirsten Falch, Oke Gerke, Jeanette Hansen, Tram Nguyen, Abass Alavi, Poul-Flemming Høilund-Carlsen, Malene G. Hildebrandt

Published in: BMC Medical Imaging | Issue 1/2018

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Abstract

Background

Several studies have shown the advantage of delayed-time-point imaging with 18F-FDG-PET/CT to distinguish malignant from benign uptake. This may be relevant in cancer diseases with low metabolism, such as breast cancer. We aimed at examining the change in SUV from 1 h (1h) to 3 h (3h) time-point imaging in local and distant lesions in patients with recurrent breast cancer. Furthermore, we investigated the effect of partial volume correction in the different types of metastases, using semi-automatic quantitative software (ROVER™).

Methods

One-hundred and two patients with suspected breast cancer recurrence underwent whole-body PET/CT scans 1h and 3h after FDG injection. Semi-quantitative standardised uptake values (SUVmax, SUVmean) and partial volume corrected SUVmean (cSUVmean), were estimated in malignant lesions, and as reference in healthy liver tissue. The change in quantitative measures from 1h to 3h was calculated, and SUVmean was compared to cSUVmean. Metastases were verified by biopsy.

Results

Of the 102 included patients, 41 had verified recurrent disease with in median 15 lesions (range 1-70) amounting to a total of 337 malignant lesions included in the analysis. SUVmax of malignant lesions increased from 6.4 ± 3.4 [0.9-19.7] (mean ± SD, min and max) at 1h to 8.1 ± 4.4 [0.7-29.7] at 3h. SUVmax in breast, lung, lymph node and bone lesions increased significantly (p < 0.0001) between 1h and 3h by on average 25, 40, 33, and 27%, respectively. A similar pattern was observed with (uncorrected) SUVmean. Partial volume correction increased SUVmean significantly, by 63 and 71% at 1h and 3h imaging, respectively. The highest impact was in breast lesions at 3h, where cSUVmean increased by 87% compared to SUVmean.

Conclusion

SUVs increased from 1h to 3h in malignant lesions, SUVs of distant recurrence were in general about twice as high as those of local recurrence. Partial volume correction caused significant increases in these values. However, it is questionable, if these relatively modest quantitative advances of 3h imaging are sufficient to warrant delayed imaging in this patient group.

Trial registration

ClinicalTrails.gov NCT01552655. Registered 28 February 2012, partly retrospectively registered.
Appendix
Available only for authorised users
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Metadata
Title
Quantification of FDG-PET/CT with delayed imaging in patients with newly diagnosed recurrent breast cancer
Authors
Christina Baun
Kirsten Falch
Oke Gerke
Jeanette Hansen
Tram Nguyen
Abass Alavi
Poul-Flemming Høilund-Carlsen
Malene G. Hildebrandt
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Medical Imaging / Issue 1/2018
Electronic ISSN: 1471-2342
DOI
https://doi.org/10.1186/s12880-018-0254-8

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