Correlación entre la captación de 18F-FDG del tumor primario con los factores pronósticos y subtipo molecular del cáncer ductal de mama / Relationships of 18F-FDG uptake by primary tumors with prognostic factors and molecular subtype in ductal breast cancer

Objetivos: En este estudio nos propusimos investigar la correlación entre el SUVmáx del tumor primario y los factores de pronóstico/subtipo molecular en pacientes con cáncer de mama ductal.Materiales y métodos: Revisamos retrospectivamente a 150 pacientes mujeres con cáncer de mama ductal invasivo patológicamente comprobado desde enero de 2015 hasta octubre de 2019 que se sometieron a una PET/TC con 18F-FDG para la estadificación inicial. Las características pronósticas histopatológicas del tumor primario (grado histológico, estado de los receptores hormonales, índice Ki-67) se obtuvieron del informe de la biopsia tru-cut. En los estudios PET/TC con 18F-FDG se calculó el valor máximo de captación estandarizada (SUVmáx) del tumor primario de mama y se comparó con la presencia de linfadenopatía axilar y/o metástasis a distancia, factores pronósticos histopatológicos y subtipo molecular.Resultados: El alto SUVmáx de los tumores de mama primarios está significativamente correlacionado con los factores clínico-patológicos: gran tamaño del tumor, alto grado histológico, alto índice Ki-67, positividad de los ganglios linfáticos axilares y metástasis a distancia. El valor SUVmáx fue significativamente más alto en los pacientes con subtipo basal que en los pacientes con subtipo luminal A (8,14 ± 3,71 y 4,64 ± 2,45, p = 0,002). El análisis de correlación reveló una baja correlación entre el índice Ki-67 y el SUVmáx (r = 0,276, p = 0,001) y una correlación moderada entre el tamaño del tumor y el SUVmáx (r = 0,470, p = 0,001). En el análisis de regresión multivariante de líneas el índice Ki-67 y el tamaño del tumor tuvieron un efecto estadísticamente significativo en los valores del SUVmáx. A medida que estos parámetros aumentan se observa un incremento de los valores SUVmáx (p = 0,004, Std Beta: 0,228, IC 95%: 0,010-0,055 y p = 0,001, Std Beta: 0,374, IC 95%: 0,55-0,136, respectivamente).Conclusión: El alto valor SUVmáx se asocia con factores pronósticosmal

Objectives: In this study, we aimed to investigate the correlation between SUVmax of primary tumor and prognostic factors/molecular subtype in ductal breast cancer patients.Materials and methods: We retrospectively reviewed 150 female patients with pathologically proven invasive ductal breast cancer from January 2015 to October 2019 who underwent 18F-FDG PET/CT for initial staging. Histopathological prognostic features of the primary tumor (histological grade, hormone receptor status, Ki-67 index, vb.) were obtained from the tru-cut biopsy report. In 18F-FDG PET/CT studies, the maximum standardized uptake value (SUVmax) of the primary breast tumor was calculated and compared with the presence of axillary lymphadenopathy and/or distant metastases, histopathological prognostic factors and molecular subtype.Results: The high SUVmax of primary breast tumors is significantly correlated with the clinicopathological factors: high tumor size, high histologic grade, high Ki-67 index, axillary lymph node positivity and distant metastasis. SUVmax value was significantly higher in patients with basal subtype than patients with Luminal A subtype (8.14 ± 3.71 and 4.64 ± 2.45, p = 0.002). Correlation analysis revealed a low correlation between Ki-67 index and SUVmax (r = 0.276, p = 0.001) and moderate correlation between tumor size and SUVmax (r = 0.470, p = 0.001). In multivariate linear regression analysis, Ki-67 index and tumor size had a statistically significant effect on SUVmax values. As these parameters increase, it is seen that it increases SUVmax values (p = 0.004, Std Beta: 0.228, 95% CI: 0.010–0.055 and p = 0.001, Std Beta: 0.374, 95% CI: 0.55–0.136, respectively).Conclusión: High SUVmax value is associated with prognotic factors suggesting poor prognosis. Pretreatment 18F-FDG PET/CT can be used as a tool to predict prognosis in breast cancer (AU)

Relationships of 18F-FDG uptake by primary tumors with prognostic factors and molecular subtype in ductal breast cancer.

OBJECTIVES: In this study, we aimed to investigate the correlation between SUVmax of primary tumor and prognostic factors/molecular subtype in ductal breast cancer patients. MATERIALS AND METHODS: We retrospectively reviewed 150 female patients with pathologically proven invasive ductal breast cancer from January 2015 to October 2019 who underwent 18F-FDG PET/CT for initial staging. Histopathological prognostic features of the primary tumor (histological grade, hormone receptor status, Ki-67 index, vb.) were obtained from the tru-cut biopsy report. In 18F-FDG PET/CT studies, the maximum standardized uptake value (SUVmax) of the primary breast tumor was calculated and compared with the presence of axillary lymphadenopathy and/or distant metastases, histopathological prognostic factors and molecular subtype. RESULTS: The high SUVmax of primary breast tumors is significantly correlated with the clinicopathological factors: high tumor size, high histologic grade, high Ki-67 index, axillary lymph node positivity and distant metastasis. SUVmax value was significantly higher in patients with basal subtype than patients with Luminal A subtype (8.14±3.71 and 4.64±2.45, p=0.002). Correlation analysis revealed a low correlation between Ki-67 index and SUVmax (r=0.276, p=0.001) and moderate correlation between tumor size and SUVmax (r=0.470, p=0.001). In multivariate linear regression analysis, Ki-67 index and tumor size had a statistically significant effect on SUVmax values. As these parameters increase, it is seen that it increases SUVmax values (p=0.004, Std Beta: 0.228, 95% CI: 0.010-0.055 and p=0.001, Std Beta: 0.374, 95% CI: 0.55-0.136, respectively). CONCLUSION: High SUVmax value is associated with prognotic factors suggesting poor prognosis. Pretreatment 18F-FDG PET/CT can be used as a tool to predict prognosis in breast cancer.

Aportación clínica de la SPECT/TC en la gammagrafía con leucocitos marcados con 99mTc-HMPAO en infección de prótesis de cadera y rodilla / The clinical contribution of SPECT/CT with 99mTc-HMPAO-labeled leukocyte scintigraphy in hip and knee prosthetic infections

OBJETIVO: La gammagrafía con leucocitos marcados con 99mTc-HMPAO ha resultado un método de estudio específico y altamente sensible en el diagnóstico y seguimiento de pacientes con sospecha de infección protésica. El objetivo de este estudio retrospectivo fue evaluar la utilidad de la SPECT/TC en infección protésica. MATERIAL Y MÉTODOS: Se realizó una gammagrafía con leucocitos marcados con 99mTc-HMPAO a 37 pacientes con prótesis articular (11 hombres y 26 mujeres; rango de edades de 38 a 84 años; edad media+/-DE, 65,7+/-5,6 años). Se obtuvieron imágenes planares 2, 4 y 24horas después de la inyección. A las 4horas se realizó SPECT/TC usando una gammacámara híbrida de doble detector con TC de baja energía. En todos los pacientes se compararon los resultados de la gammagrafía con los resultados de la intervención quirúrgica, el cultivo y el seguimiento clínico. RESULTADOS: De 37 pacientes estudiados con leucocitos marcados con 99mTc-HMPAO, con gammagrafía y SPECT/TC, 17 (45,9%) tenían infección protésica y 20 (54,1%) tenían afecciones protésicas no infecciosas. La gammagrafía con leucocitos marcados con 99mTc-HMPAO fue verdadero positivo para infección en 16 de 37 pacientes y verdadero negativo en 20 de 37 pacientes. La SPECT/TC proporciona una localización anatómica precisa de todos los posibles focos. Considerando el diagnóstico final, la SPECT/TC aportó una contribución clínica significativa en 22 de 37 pacientes (59,4%). La sensibilidad, especificidad, valor predictivo negativo y valor predictivo positivo fueron del 100%, 59,1%, 100%, 62,5% en las imágenes planares y de 100%, 90,1%, 100%, 88,2% en la imagen planar más SPECT/TC respectivamente. DISCUSIÓN: Nuestros resultados indican que la realización de la SPECT/TC puede mejorar el estudio con leucocitos marcados con 99mTc-HMPAO en pacientes con sospecha de osteomielitis, y proporcionar una localización anatómica y una definición precisa del alcance de la infección

OBJECTIVES: White blood cell scanning with 99mTc-hexamethylpropylene amine oxime (HMPAO) has proven a sensitive and specific imaging method in the diagnosis of suspected prosthesis infection. The aim of this retrospective study was to evaluate the usefulness of SPECT/CT performed simultaneously using a hybrid imaging device of prosthesis infections. MATERIALS AND METHODS: 99mTc-HMPAO scintigraphy was performed on 37 patients (11 men and 26 women; age range 38-84 years; mean age+/-SD, 65.7+/-5.6 years). Planar scans were acquired 2.4 and 24hour after injection. SPECT/CT was obtained 4 h after injection, using a dual-head hybrid gama camera coupled with a low-power x-ray tube. In all patients, scintigraphic results were matched with the results of surgery, cultures and clinical follow-up. RESULTS: Seventeen (45,9%) out of 37 patients had prosthesis infection and 20 (54,1%) out of 37 patients had non-infectious prosthesis pathologies with 99mTc-HMPAO scintigraphy and SPECT/CT. The 99mTc-HMPAO scintigraphy was true-positive for infection in 16 of 37 patients and true-negative in 20 of 37 patients. SPECT/CT provided an accurate anatomic localization of all positive foci. With regard to the final diagnosis, SPECT/CT added a significant clinical contribution in 22 of 37 patients (59,4%). Sensitivity, specificity, negative predictive value and positive predictive values were 100%,59.1%,100%,62.5% in planar images with 99mTc-HMPAO scintigraphy and 100%,90.1%,100%,88.2% in the planar+SPECT/CT imaging, respectively. DISCUSSION: Our results indicate that SPECT/CT performed using a hybrid device can improve imaging with 99mTc-HMPAO scintigraphy in patients with suspected osteomyelitis by providing accurate anatomic localization and precise definition of the extent of infection

The clinical contribution of SPECT/CT with 99mTc-HMPAO-labeled leukocyte scintigraphy in hip and knee prosthetic infections. / Aportación clínica de la SPECT/TC en la gammagrafía con leucocitos marcados con 99mTc-HMPAO en infección de prótesis de cadera y rodilla.

OBJECTIVES: White blood cell scanning with 99mTc-hexamethylpropylene amine oxime (HMPAO) has proven a sensitive and specific imaging method in the diagnosis of suspected prosthesis infection. The aim of this retrospective study was to evaluate the usefulness of SPECT/CT performed simultaneously using a hybrid imaging device of prosthesis infections. MATERIALS AND METHODS: 99mTc-HMPAO scintigraphy was performed on 37 patients (11 men and 26 women; age range 38-84 years; mean age±SD, 65.7±5.6 years). Planar scans were acquired 2.4 and 24hour after injection. SPECT/CT was obtained 4 h after injection, using a dual-head hybrid gama camera coupled with a low-power x-ray tube. In all patients, scintigraphic results were matched with the results of surgery, cultures and clinical follow-up. RESULTS: Seventeen (45,9%) out of 37 patients had prosthesis infection and 20 (54,1%) out of 37 patients had non-infectious prosthesis pathologies with 99mTc-HMPAO scintigraphy and SPECT/CT. The 99mTc-HMPAO scintigraphy was true-positive for infection in 16 of 37 patients and true-negative in 20 of 37 patients. SPECT/CT provided an accurate anatomic localization of all positive foci. With regard to the final diagnosis, SPECT/CT added a significant clinical contribution in 22 of 37 patients (59,4%). Sensitivity, specificity, negative predictive value and positive predictive values were 100%,59.1%,100%,62.5% in planar images with 99mTc-HMPAO scintigraphy and 100%,90.1%,100%,88.2% in the planar+SPECT/CT imaging, respectively. DISCUSSION: Our results indicate that SPECT/CT performed using a hybrid device can improve imaging with 99mTc-HMPAO scintigraphy in patients with suspected osteomyelitis by providing accurate anatomic localization and precise definition of the extent of infection.

Tumor grade-related thallium-201 uptake in chondrosarcomas.

OBJECTIVES: Diagnosis of low-grade chondrosarcoma, especially discrimination between enchondroma and low-grade chondrosarcoma, may be difficult pathologically. The aim of this study was to evaluate the value of thallium-201 (Tl-201) scintigraphy in the diagnosis of chondrosarcoma and to investigate whether there was a correlation between Tl-201 uptake and tumor grade. METHODS: We retrospectively evaluated 121 patients with pathologically proven bone and soft tissue tumors diagnosed between the years 1999 and 2007. All patients were followed by the Bone and Soft Tissue Tumor Working Group in our hospital. Twenty-three patients, mean age 44 +/- 15 (range 17-72) years, with a diagnosis of cartilaginous tumors were included. Increased Tl-201 uptake at the lesion sites greater than background was evaluated as malignant tumor. For the pathologic classification, a grading system (grade 1-3) based on the histopathologic findings was used. Pearson correlation coefficient was used to determine whether there was any correlation between Tl-201 uptake and tumor grade in chondrosarcoma. RESULTS: There were 7 enchondromas and 16 chondrosarcomas. Four of 16 patients with chondrosarcoma had lesions pathologically classified as grade 3, 5 as grade 2, and 7 had grade 1 chondrosarcoma. Increased Tl-201 uptake was observed in all patients with grade 3 chondrosarcoma and 2 patients with grade 2 chondrosarcoma. Of 10 patients with chondrosarcoma, 3 grade 2 chondrosarcomas and 7 grade 1 chondrosarcomas, there was no Tl-201 uptake in the tumor region. A significant correlation was found between Tl-201 uptake and tumor grade in chondrosarcoma (p = 0.002, r = 0.71). Only a few reports in literature have demonstrated false negative results in low-grade chondrosarcoma. CONCLUSION: Tl-201 uptake was related to tumor grade in chondrosarcoma. If there is a possibility of chondrosarcoma, Tl-201 scintigraphy should be reported with caution.