ADC of Diffusion-weighted MRI and SUVmax of 18F-FDG-PET/CT: Correlation with Prognostic Factors and Distant Metastasis in Breast Cancer
Kevser Esmeray ÇIFCI1,Mehmet Ali NAZLI2,Melis BAYKARA ULUSAN3,Esra ARSLAN4
1Department of Radiology, Kocaeli Darıca Farabi Training and Research Hospital, Kocaeli-Türkiye
2Department of Radiology, Başakşehir Çam and Sakura City Hospital, İstanbul-Türkiye
3Department of Radiology, University of Health Sciences, İstanbul Training and Research Hospital, İstanbul-Türkiye
4Department of Nuclear Medicine, University of Health Sciences, İstanbul Training and Research Hospital, İstanbul-Türkiye
DOI : 10.5505/tjo.2023.3473 OBJECTIVE
We aimed to evaluate the relationship between apparent diffusion coefficient (ADC), maximum standardized uptake value (SUVmax), and prognostic factors in breast cancer (BC) and to investigate the contribution of these parameters in determining the distant metastases at the time of diagnosis in BC.

The study included 209 patients with invasive BC at the time of initial diagnosis. Patients underwent whole-body 18F-fluorodeoxyglocose positron emission tomography/computed tomography and breast magnetic resonance imaging including diffusion weighted imaging. Histologic grade (HG), histological type, human epidermal growth factor 2 (HER-2), Ki-67, estrogen receptor (ER), and progesterone receptor (PR) markers of the breast tumor were evaluated in pathological samples. Tumor-node-metastasis (TNM) staging was performed based on clinical, pathological, and imaging findings.

HER-2 positivity and PR positivity demonstrated a strong correlation with distant metastasis (p=0.00040 ve 0.00045). ER positivity was positively correlated with SUVmax (p=0.0001) and SUVmax/ADCmean (p=0.006). PR was positively correlated with ADCmean (0.028). SUVmax was correlated with the tumor size (p=0.008), TNM stage (p=0.022 and r=0.159), and HG (p<0.0001 and r=0.347).

Both SUVmax and ADCmean are helpful parameters in determining prognosis in BC. HER-2 and PR positivity, and tumor size can be used as revealing and useful parameters in determining distant metastases. Keywords : Apperent diffusion coefficient; breast cancer; diffusion-weighted magnetic resonance imaging; positron emission tomography