Prognostic Value of Metabolic, Volumetric and Textural Parameters of Baseline [18F]FDG PET/CT in Early Triple-Negative Breast Cancer
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Clinical and Histological Parameters
2.3. [18F]FDG PET/CT Examination
2.4. [18F]FDG PET/CT Imaging Analysis
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- SUV: calculated using the following equation:SUV = (tissue radioactivity [Bq]/tissue weight [g])/(injected activity [Bq]/body weight [g]).
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- Max: highest value of a voxel in the VOI
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- Mean: mean value of all voxels in the VOI
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- Peak: mean value of all voxels in 1 cm3 centered around the highest voxel value
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- MTV: considered as the volume of all voxels included in the VOI
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- TLG: defined by the formula SUVmean × MTV
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- Homogeneity: measures the local homogeneity of a pixel pair—homogeneity is expected to be large if each pixel pair’s gray levels are similar.
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- Entropy: measures the randomness of a gray-level distribution—the entropy is expected to be high if the gray levels are distributed randomly throughout the tumor region.
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- Short-Run Emphasis (SRE): measures the distribution of short series—the value is expected to be large if the number of short series is high.
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- Long-Run Emphasis (LRE): measures the distribution of long series—the value is expected to be large if the number of long series is high.
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- Low-Gray-level Zone Emphasis (LGZE): measures the distribution of low-gray-level zones.
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- High-Gray-level Zone Emphasis (HGZE): measures the distribution of high-gray-level zones.
2.5. Statistical Analysis
3. Results
3.1. Patient Inclusion
3.2. Comparison of Raw and Harmonized Data
3.3. Patient Characteristics and PET/CT Baseline Parameters
3.4. PET/CT Features with Clinical and Histological Factors
3.5. Tumor Characteristics, Therapeutic Management and PET/CT Features with Prognostic Factors
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patient Information | Mean [min–max] | SD |
---|---|---|
Age | 52.6 [25–90] | 14.7 |
Tumor characteristics | n = 111 | % |
Inflammatory tumor | 12 | 10.9 |
T stage | ||
T1–T2 | 80 | 71.8 |
T3–T4 | 31 | 28.2 |
N stage | ||
cN0 | 70 | 62.7 |
cN+ | 41 | 37.3 |
Ductal carcinoma | 104 | 93.7 |
mSBR grade | ||
2 | 8 | 7.2 |
3 | 103 | 92.8 |
Mitoses (n = 106) | ||
1 | 5 | 4.7 |
2 | 17 | 16.0 |
3 | 84 | 79.2 |
Associated in situ carcinoma | 25 | 27.5 |
Ki67 ≥ 20% | 94 | 91.3 |
Unifocal tumor Multifocal tumor | 86 25 | 77.5 22.5 |
Lymphovascular emboli | 22 | 21.6 |
Therapy | n = 111 | % |
Chemotherapy (CT) | ||
Adjuvant | 29 | 27.1 |
Neoadjuvant | 78 | 72.9 |
Type of CT | ||
Anthracyclines + taxanes | 81 | 76.4 |
Without anthracyclines | 3 | 2.8 |
Platinum salts | 22 | 20.8 |
Tumor surgery | ||
Conservative | 73 | 65.8 |
Radical | 38 | 34.2 |
Lymph node surgery | ||
Dissection | 66 | 59.5 |
Sentinel | 45 | 40.5 |
Radiotherapy | ||
Yes | 104 | 94.5 |
No | 7 | 5.5 |
(pCR) (n = 74) | ||
Yes | 22 | 29.7 |
No | 52 | 70.3 |
PET/CT imaging | n = 111 | % |
NPET stage | ||
N0PET | 61 | 55.0 |
N+PET | 50 | 45.0 |
PET Parameters | Mean (SD) | Median (IQR) |
---|---|---|
SUVmax | 14.6 (7.6) | 12.8 (9.6–18.3) |
SUVmean | 5.8 (2.1) | 5.3 (4.5–6.65) |
SUVpeak | 12.1 (5.9) | 10.9 (7.9–14.2) |
MTV | 22.57 (46.99) | 6.8 (2.9–18.1) |
TLG | 191.33 (578.25) | 37.5 (13.65–110.1) |
Variables | Homogeneity p-Value | MTV p-Value | Entropy p-Value | SRE p-Value |
---|---|---|---|---|
T3–T4 vs. T1–T2 | 0.614 | <0.001 | <0.001 | 0.545 |
cN+ vs. cN0 | 0.403 | <0.001 | 0.027 | 0.713 |
N+PET vs. N0PET | 0.037 | <0.001 | 0.001 | 0.164 |
Inflammatory tumor | 0.117 | <0.001 | <0.001 | 0.511 |
mSBR 3 vs. 2 | 0.004 | 0.321 | 0.020 | 0.044 |
Unifocal vs. multifocal | 0.522 | 0.094 | 0.661 | 0.666 |
Variables | DFS | OS | ||
---|---|---|---|---|
HR (95% CI) | p | HR (95% CI) | p | |
Tumor characteristics | ||||
Inflammatory: yes | 2.79 (1.14; 6.81) | 0.025 | 4.53 (1.61; 12.78) | 0.004 |
T3–T4 vs. T1–T2 | 1.56 (0.77; 3.17) | 0.220 | 2.78 (1.16; 6.69) | 0.022 |
cN+ vs. cN0 | 3.3 (1.62; 6.71) | 0.001 | 2.58 (1.06; 6.32) | 0.038 |
mSBR 3 vs. 2 | 1.47 (0.35; 6.14) | 0.599 | 1.85 (0.25; 13.84) | 0.549 |
Associated in situ carcinoma: yes | 1.51 (0.64; 3.53) | 0.343 | 2.27 (0.86; 6.02) | 0.099 |
Ki67 ≥ 20% vs. Ki 67 < 20% | 0.63 (0.19; 2.1) | 0.452 | 0.69 (0.16; 3.01) | 0.624 |
Unifocal vs. multifocal tumor | 0.51 (0.25; 1.04) | 0.066 | 0.21 (0.08; 0.5) | <0.001 |
Therapy | ||||
NAC vs. adjuvant CT | 1.8 (0.69; 4.69) | 0.226 | 2.78 (0.64; 11.98) | 0.171 |
Without anthracyclines vs. anthracyclines | 16.38 (4.6; 58.37) | <0.001 | 36.36 (8.28; 159.64) | <0.001 |
Platin salts vs. anthracyclines | 3.76 (1.73; 8.16) | 0.001 | 8.2 (3.07; 21.91) | <0.001 |
Radical surgery/conservative surgery | 1.56 (0.79; 3.09) | 0.202 | 4.04 (1.61; 10.14) | 0.003 |
pCR vs. absence of pCR | 0.17 (0.04; 0.73) | 0.017 | 0.33 (0.07; 1.45) | 0.141 |
PET/CT Parameters | DFS | OS | ||
---|---|---|---|---|
HR (95% CI) | p | HR (95% CI) | p | |
N+PET vs. N0PET | 2.91 (1.42; 5.97) | 0.004 | 3.85 (1.4; 10.59) | 0.009 |
SUVmax | 1.03 (0.99; 1.07) | 0.131 | 1.04 (0.99; 1.09) | 0.153 |
SUVmean | 1.07 (0.92; 1.24) | 0.361 | 1.11 (0.92; 1.34) | 0.267 |
SUVpeak | 1.03 (0.98; 1.09) | 0.260 | 1.04 (0.97; 1.12) | 0.232 |
MTV | 1.39 (1.1; 1.76) | 0.006 | 1.7 (1.24; 2.33) | 0.001 |
TLG | 1.31 (1.07; 1.6) | 0.008 | 1.53 (1.17; 2.01) | 0.002 |
Entropy | 2.08 (1.1; 3.96) | 0.025 | 2.46 (1.02; 5.97) | 0.046 |
Homogeneity | 0.19 (0; 10.58) | 0.421 | 0.13 (0; 30.74) | 0.469 |
SRE | 7.49 (0; 88,438,904.54) | 0.809 | 6.79 (0; 24,884,680,339.1) | 0.865 |
LRE | 1.38 (0.03; 57.66) | 0.864 | 2.33 (0.02; 277.48) | 0.729 |
LGZE | 0.47 (0.18; 1.21) | 0.118 | 0.34 (0.09; 1.25) | 0.105 |
HGZE | 1.48 (0.96; 2.3) | 0.078 | 1.61 (0.91; 2.86) | 0.101 |
Parameters | DFS | OS | ||
---|---|---|---|---|
p-Value | HR (95% CI) | p-Value | HR (95% CI) | |
MTV | 0.125 | 0.014 | 1.52 (1.09; 2.12) | |
TLG | 0.158 | - | ||
Entropy | 0.192 | - | ||
SUVmax | - | - | ||
N+PET vs. N0PET | 0.036 | 2.36 (1.06; 5.24) | 0.074 | |
Inflam | - | - | ||
T3–T4 vs. T1–T2 | - | - |
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Bouron, C.; Mathie, C.; Seegers, V.; Morel, O.; Jézéquel, P.; Lasla, H.; Guillerminet, C.; Girault, S.; Lacombe, M.; Sher, A.; et al. Prognostic Value of Metabolic, Volumetric and Textural Parameters of Baseline [18F]FDG PET/CT in Early Triple-Negative Breast Cancer. Cancers 2022, 14, 637. https://doi.org/10.3390/cancers14030637
Bouron C, Mathie C, Seegers V, Morel O, Jézéquel P, Lasla H, Guillerminet C, Girault S, Lacombe M, Sher A, et al. Prognostic Value of Metabolic, Volumetric and Textural Parameters of Baseline [18F]FDG PET/CT in Early Triple-Negative Breast Cancer. Cancers. 2022; 14(3):637. https://doi.org/10.3390/cancers14030637
Chicago/Turabian StyleBouron, Clément, Clara Mathie, Valérie Seegers, Olivier Morel, Pascal Jézéquel, Hamza Lasla, Camille Guillerminet, Sylvie Girault, Marie Lacombe, Avigaelle Sher, and et al. 2022. "Prognostic Value of Metabolic, Volumetric and Textural Parameters of Baseline [18F]FDG PET/CT in Early Triple-Negative Breast Cancer" Cancers 14, no. 3: 637. https://doi.org/10.3390/cancers14030637