Appearance of untreated bone metastases from breast cancer on FDG PET/CT: Importance of histologic subtype Journal Article

Authors: Dashevsky, B. Z.; Goldman, D. A.; Parsons, M.; Gönen, M.; Corben, A. D.; Jochelson, M. S.; Hudis, C. A.; Morrow, M.; Ulaner, G. A.
Article Title: Appearance of untreated bone metastases from breast cancer on FDG PET/CT: Importance of histologic subtype
Abstract: Purpose: To determine if the histology of a breast malignancy influences the appearance of untreated osseous metastases on FDG PET/CT. Methods: This retrospective study was performed under IRB waiver. Our Hospital Information System was screened for breast cancer patients who presented with osseous metastases, who underwent FDG PET/CT prior to systemic therapy or radiotherapy from 2009 to 2012. Patients with invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC), or mixed ductal/lobular (MDL) histology were included. Patients with a history of other malignancies were excluded. PET/CT was evaluated, blinded to histology, to classify osseous metastases on a per-patient basis as sclerotic, lytic, mixed lytic/sclerotic, or occult on CT, and to record SUVmax for osseous metastases on PET. Results: Following screening, 95 patients who met the inclusion criteria (74 IDC, 13 ILC, and 8 MDL) were included. ILC osseous metastases were more commonly sclerotic and demonstrated lower SUVmax than IDC metastases. In all IDC and MDL patients with osseous metastases, at least one was FDG-avid. For ILC, all patients with lytic or mixed osseous metastases demonstrated at least one FDG-avid metastasis; however, in only three of seven patients were sclerotic osseous metastases apparent on FDG PET. Conclusion: The histologic subtype of breast cancer affects the appearance of untreated osseous metastases on FDG PET/CT. In particular, non-FDG-avid sclerotic osseous metastases were more common in patients with ILC than in patients with IDC. Breast cancer histology should be considered when interpreting non-FDG-avid sclerotic osseous lesions on PET/CT, which may be more suspicious for metastases (rather than benign lesions) in patients with ILC. © 2015, Springer-Verlag Berlin Heidelberg.
Keywords: adult; controlled study; human tissue; aged; major clinical study; systemic therapy; bone metastasis; cancer radiotherapy; follow up; breast cancer; retrospective study; electronic medical record; breast carcinoma; fluorodeoxyglucose f 18; computer assisted emission tomography; pet/ct; ductal; bone biopsy; osseous metastases; lobular; human; female; article; pet-ct scanner
Journal Title: European Journal of Nuclear Medicine and Molecular Imaging
Volume: 42
Issue: 11
ISSN: 1619-7070
Publisher: Springer  
Date Published: 2015-10-01
Start Page: 1666
End Page: 1673
Language: English
DOI: 10.1007/s00259-015-3080-z
PROVIDER: scopus
PMCID: PMC4558334
PUBMED: 25971426
Notes: Export Date: 2 October 2015 -- Source: Scopus
Citation Impact
MSK Authors
  1. Monica Morrow
    714 Morrow
  2. Adriana Dionigi Corben
    65 Corben
  3. Gary Ulaner
    144 Ulaner
  4. Clifford Hudis
    904 Hudis
  5. Mithat Gonen
    946 Gonen
  6. Maxine Jochelson
    116 Jochelson
  7. Debra Alyssa Goldman
    154 Goldman