Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Aug 28, 2016; 8(8): 743-749
Published online Aug 28, 2016. doi: 10.4329/wjr.v8.i8.743
Tumor characteristics of ductal carcinoma in situ of breast visualized on [F-18] fluorodeoxyglucose-positron emission tomography/computed tomography: Results from a retrospective study
Tomoyuki Fujioka, Kazunori Kubota, Akira Toriihara, Youichi Machida, Kaori Okazawa, Tsuyoshi Nakagawa, Yukihisa Saida, Ukihide Tateishi
Tomoyuki Fujioka, Kazunori Kubota, Akira Toriihara, Kaori Okazawa, Yukihisa Saida, Ukihide Tateishi, Department of Diagnostic Radiology, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
Youichi Machida, Department of Radiology, Kameda Kyobashi Clinic, Tokyo 104-0031, Japan
Tsuyoshi Nakagawa, Department of Breast Surgery, Tokyo Medical and Dental University, Tokyo 113-8519, Japan
Author contributions: Fujioka T, Kubota K, Toriihara A, Machida Y, Okazawa K, Nakagawa T, Saida Y and Tateishi U designed the research study.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Tokyo Medical and Dental University Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ukihide Tateishi, MD, Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. utateish@yokohama-cu.ac.jp
Telephone: +81-3-58035311 Fax: +81-3-58030147
Received: January 25, 2016
Peer-review started: January 25, 2016
First decision: February 29, 2016
Revised: May 2, 2016
Accepted: May 31, 2016
Article in press: June 2, 2016
Published online: August 28, 2016
Processing time: 213 Days and 22.6 Hours
Abstract
AIM

To clarify clinicopathological features of ductal carcinoma in situ (DCIS) visualized on [F-18] fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT).

METHODS

This study retrospectively reviewed 52 consecutive tumors in 50 patients with pathologically proven pure DCIS who underwent [F-18] FDG-PET/CT before surgery. [F-18] FDG-PET/CT was performed after biopsy in all patients. The mean interval from biopsy to [F-18] FDG-PET/CT was 29.2 d. [F-18] FDG uptake by visual analysis and maximum standardized uptake value (SUVmax) was compared with clinicopathological characteristics.

RESULTS

[F-18] FDG uptake was visualized in 28 lesions (53.8%) and the mean and standard deviation of SUVmax was 1.63 and 0.90. On univariate analysis, visual analysis and the SUVmax were associated with symptomatic presentation (P = 0.012 and 0.002, respectively), palpability (P = 0.030 and 0.024, respectively), use of core-needle biopsy (CNB) (P = 0.023 and 0.012, respectively), ultrasound-guided biopsy (P = 0.040 and 0.006, respectively), enhancing lesion ≥ 20 mm on magnetic resonance imaging (MRI) (P = 0.001 and 0.010, respectively), tumor size ≥ 20 mm on histopathology (P = 0.002 and 0.008, respectively). However, [F-18] FDG uptake parameters were not significantly associated with age, presence of calcification on mammography, mass formation on MRI, presence of comedo necrosis, hormone status (estrogen receptor, progesterone receptor and human epidermal growth factor receptor-2), and nuclear grade. The factors significantly associated with visual analysis and SUVmax were symptomatic presentation (P = 0.019 and 0.001, respectively), use of CNB (P = 0.001 and 0.031, respectively), and enhancing lesion ≥ 20 mm on MRI (P = 0.001 and 0.049, respectively) on multivariate analysis.

CONCLUSION

Although DCIS of breast is generally non-avid tumor, symptomatic and large tumors (≥ 20 mm) tend to be visualized on [F-18] FDG-PET/CT.

Keywords: Ductal carcinoma in situ; Positron emission tomography; Breast cancer; [F-18] fluorodeoxyglucose-positron emission tomography/computed tomography

Core tip: Symptomatic tumor or large ductal carcinoma in situ (DCIS) (≥ 20 mm) is often visualized on [F-18] fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT). This evidence suggests that large DCIS (≥ 20 mm) has possibility to be selected as target lesion on [F-18] FDG-PET/CT prior to neoadjuvant chemotherapy.