Charles Lemarignier1,2, Antoine Martineau3, Luis Teixeira4,5, Laetitia Vercellino3, Marc Espié4,5, Pascal Merlet3, David Groheux3,5. 1. Department of Nuclear Medicine, Saint-Louis Hospital, Assistance Publique - Hôpitaux de Paris, 1 avenue Claude Vellefaux, 75475, Paris Cedex 10, France. charles.lemarignier@aphp.fr. 2. University Sorbonne Paris Cité, INSERM/CNRS UMR944/7212, Paris, France. charles.lemarignier@aphp.fr. 3. Department of Nuclear Medicine, Saint-Louis Hospital, Assistance Publique - Hôpitaux de Paris, 1 avenue Claude Vellefaux, 75475, Paris Cedex 10, France. 4. Breast Diseases Unit, Saint-Louis Hospital, Paris, France. 5. University Sorbonne Paris Cité, INSERM/CNRS UMR944/7212, Paris, France.
Abstract
PURPOSE: The study was designed to evaluate 1) the relationship between PET image textural features (TFs) and SUVs, metabolic tumour volume (MTV), total lesion glycolysis (TLG) and tumour characteristics in a large prospective and homogenous cohort of oestrogen receptor-positive (ER+) breast cancer (BC) patients, and 2) the capability of those parameters to predict response to neoadjuvant chemotherapy (NAC). METHODS: 171 consecutive patients with large or locally advanced ER+ BC without distant metastases underwent an 18F-FDG PET examination before NAC. The primary tumour was delineated with an adaptive threshold segmentation method. Parameters of volume, intensity and texture (entropy, homogeneity, contrast and energy) were measured and compared with tumour characteristics determined on pre-treatment breast biopsy (Wilcoxon rank-sum test). The correlation between PET-derived parameters was determined using Spearman's coefficient. The relationship between PET features and pathological findings was determined using the Wilcoxon rank-sum test. RESULTS: Spearman's coefficients between SUVmax and TFs were 0.43, 0.24, -0.43 and -0.15 respectively for entropy, homogeneity, energy and contrast; they were higher between MTV and TFs: 0.99, 0.86, -0.99 and -0.87. All TFs showed a significant association with the histological type (IDC vs. ILC; 0.02 < P < 0.03) but didn't with immunohistochemical characteristics. SUVmax and TLG predicted the pathological response (P = 0.0021 and P = 0.02 respectively); TFs didn't (P: 0.27, 0.19, 0.94, 0.19 respectively for entropy, homogeneity, energy and contrast). CONCLUSIONS: The correlation of TFs was poor with SUV parameters and high with MTV. TFs showed a significant association with the histological type. Finally, while SUVmax and TLG were able to predict response to NAC, TFs failed.
PURPOSE: The study was designed to evaluate 1) the relationship between PET image textural features (TFs) and SUVs, metabolic tumour volume (MTV), total lesion glycolysis (TLG) and tumour characteristics in a large prospective and homogenous cohort of oestrogen receptor-positive (ER+) breast cancer (BC) patients, and 2) the capability of those parameters to predict response to neoadjuvant chemotherapy (NAC). METHODS: 171 consecutive patients with large or locally advanced ER+ BC without distant metastases underwent an 18F-FDG PET examination before NAC. The primary tumour was delineated with an adaptive threshold segmentation method. Parameters of volume, intensity and texture (entropy, homogeneity, contrast and energy) were measured and compared with tumour characteristics determined on pre-treatment breast biopsy (Wilcoxon rank-sum test). The correlation between PET-derived parameters was determined using Spearman's coefficient. The relationship between PET features and pathological findings was determined using the Wilcoxon rank-sum test. RESULTS: Spearman's coefficients between SUVmax and TFs were 0.43, 0.24, -0.43 and -0.15 respectively for entropy, homogeneity, energy and contrast; they were higher between MTV and TFs: 0.99, 0.86, -0.99 and -0.87. All TFs showed a significant association with the histological type (IDC vs. ILC; 0.02 < P < 0.03) but didn't with immunohistochemical characteristics. SUVmax and TLG predicted the pathological response (P = 0.0021 and P = 0.02 respectively); TFs didn't (P: 0.27, 0.19, 0.94, 0.19 respectively for entropy, homogeneity, energy and contrast). CONCLUSIONS: The correlation of TFs was poor with SUV parameters and high with MTV. TFs showed a significant association with the histological type. Finally, while SUVmax and TLG were able to predict response to NAC, TFs failed.
Entities:
Keywords:
18F-FDG PET; Breast cancer; Metabolic tumour volume; Oestrogen receptor-positive tumour; Texture features; Total lesion glycolysis
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