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Research ArticleClinical Investigations

Evaluation of Breast Tumor Blood Flow with Dynamic First-Pass 18F-FDG PET/CT: Comparison with Angiogenesis Markers and Prognostic Factors

Alexandre Cochet, Sophie Pigeonnat, Blandine Khoury, Jean-Marc Vrigneaud, Claude Touzery, Alina Berriolo-Riedinger, Inna Dygai-Cochet, Michel Toubeau, Olivier Humbert, Bruno Coudert, Pierre Fumoleau, Laurent Arnould and François Brunotte
Journal of Nuclear Medicine April 2012, 53 (4) 512-520; DOI: https://doi.org/10.2967/jnumed.111.096834
Alexandre Cochet
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Sophie Pigeonnat
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Blandine Khoury
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Jean-Marc Vrigneaud
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Claude Touzery
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Alina Berriolo-Riedinger
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Inna Dygai-Cochet
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Michel Toubeau
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Olivier Humbert
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Bruno Coudert
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Pierre Fumoleau
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Laurent Arnould
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François Brunotte
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  • FIGURE 1.
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    FIGURE 1.

    First-pass dynamic (A), early static (B), and delayed static (C) fused PET/CT images obtained, respectively, 30 s, 8 min, and 90 min after bolus injection of 18F-FDG, in 57-y-old woman with TN invasive ductal carcinoma of left breast.

  • FIGURE 2.
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    FIGURE 2.

    Spearman rank correlation with regression lines between SUVmax and Ki67 (A), tumor blood flow (BF) and Ki67 (B), SUVmax and CD34 (C), tumor blood flow and CD34 (D), SUVmax and CD105 (E), and tumor blood flow and CD105 (F). Horizontal and vertical dashed lines represent median value for each variable (6.8 for SUVmax, 60% for Ki67, 0.32 mL/min/g for blood flow, 97 for CD34, and 60 for CD105). ○ = TN breast tumors; ◆ = non-TN breast tumors.

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    FIGURE 3.

    SUVmax (A), tumor blood flow (BF) (B), and SUVmax-to-blood flow ratio (C) according to subtypes.

Tables

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    TABLE 1

    Comparison Between SUVmax and Blood Flow in the Patient and Clinical and Tumor Characteristics

    SUVmaxBlood flow (mL/min/g)
    VariableParameternMedianInterquartile rangePMedianInterquartile rangeP
    MenopausalNo22 (55%)6.75.2–9.90.480.310.23–0.380.72
    Yes18 (45%)6.85.0–14.50.320.20–0.43
    Tumor size<5 cm24 (60%)6.85.3–10.20.500.330.21–0.380.29
    ≥5 cm16 (40%)7.95.0–13.30.310.22–0.47
    Lymph node involvementNo13 (32%)5.43.9–13.00.540.280.20–0.390.40
    Yes27 (68%)7.95.5–11.70.330.23–0.42
    Histologic grade1/226 (65%)5.64.0–8.1<0.0010.270.20–0.370.030
    314 (35%)13.38.5–16.30.390.32–0.46
    ER−14 (35%)10.36.8–12.90.080.290.20–0.430.86
    +26 (65%)6.14.6–8.90.320.23–0.40
    PR−19 (48%)9.26.5–12.70.0210.360.25–0.420.18
    +21 (52%)5.53.1–9.30.280.20–0.38
    HER2−25 (63%)9.34.5–13.00.600.280.20–0.450.64
    +15 (37%)6.55.5–8.10.330.27–0.38
    TNNon-TN30 (75%)6.45.1–9.00.0420.320.23–0.390.82
    TN10 (25%)11.910.2–14.20.230.18–0.45
    Lymphovascular invasionNo6 (15%)6.95.3–11.20.650.320.21–0.380.91
    Yes34 (85%)5.43.6–12.10.280.22–0.41
    Ki67 score≤median23 (58%)5.73.5–7.0<0.0010.280.19–0.370.09
    >median17 (42%)12.17.9–14.60.380.25–0.45
    CD34 score≤median20 (50%)7.74.6–12.60.570.240.17–0.380.027
    >median20 (50%)6.65.4–10.70.360.26–0.46
    CD105 score≤median20 (50%)6.13.7–12.60.310.230.17–0.320.002
    >median20 (50%)7.56.4–11.90.370.32–0.44
    • View popup
    TABLE 2

    Predictors of High (Supramedian) SUVmax by Logistic Regression Analysis

    UnivariateMultivariate
    PredictorOR95% CIPOR95% CIP
    Histopathologic grade 36.931.53–31.40.012———
    TN breast cancer6.001.08–33.30.040———
    Ki67 score (%)1.061.02–1.090.0021.051.02–1.090.003
    • OR = odds ratio; CI = confidence interval.

    • View popup
    TABLE 3

    Predictors of High (Supramedian) Blood Flow by Logistic Regression Analysis

    UnivariateMultivariate
    PredictorOR95% CIPOR95% CIP
    Histopathologic grade 36.931.53–31.40.0129.561.60–57.20.013
    CD34 score1.011.00–1.020.046———
    CD105 score1.051.01–1.090.0111.051.01–1.090.021
    • OR = odds ratio; CI = confidence interval.

    • View popup
    TABLE 4

    Studies Evaluating Tumor Blood Flow in Patients with Large or Locally Advanced Breast Cancer

    Tumor blood flow (mL/min/g)
    StudyNo. of patientsTracerMean ± SDRange
    Wilson et al. (1992) (34)2015O-water0.30 ± 0.170.11–0.77
    Mankoff et al. (2002) (35)3715O-water0.32
    Zasadny et al. (2003) (19)915O-water0.15 ± 0.080.08–0.29
    Tseng et al. (2004) (20)3515O-water0.30
    Our study4018F-FDG0.32 ± 0.130.05–0.57
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Journal of Nuclear Medicine: 53 (4)
Journal of Nuclear Medicine
Vol. 53, Issue 4
April 1, 2012
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Evaluation of Breast Tumor Blood Flow with Dynamic First-Pass 18F-FDG PET/CT: Comparison with Angiogenesis Markers and Prognostic Factors
Alexandre Cochet, Sophie Pigeonnat, Blandine Khoury, Jean-Marc Vrigneaud, Claude Touzery, Alina Berriolo-Riedinger, Inna Dygai-Cochet, Michel Toubeau, Olivier Humbert, Bruno Coudert, Pierre Fumoleau, Laurent Arnould, François Brunotte
Journal of Nuclear Medicine Apr 2012, 53 (4) 512-520; DOI: 10.2967/jnumed.111.096834

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Evaluation of Breast Tumor Blood Flow with Dynamic First-Pass 18F-FDG PET/CT: Comparison with Angiogenesis Markers and Prognostic Factors
Alexandre Cochet, Sophie Pigeonnat, Blandine Khoury, Jean-Marc Vrigneaud, Claude Touzery, Alina Berriolo-Riedinger, Inna Dygai-Cochet, Michel Toubeau, Olivier Humbert, Bruno Coudert, Pierre Fumoleau, Laurent Arnould, François Brunotte
Journal of Nuclear Medicine Apr 2012, 53 (4) 512-520; DOI: 10.2967/jnumed.111.096834
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