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. 2024 May;58(3):113-119.
doi: 10.1007/s13139-024-00843-8. Epub 2024 Feb 1.

Association Between 18F-FDG PET Activity and HER2 Status in Breast Cancer Brain Metastases

Jonathan R Young  1 , Julie A Ressler  1 , Joanne E Mortimer  2 , Daniel Schmolze  3 , Mariko Fitzgibbons  1 , Bihong T Chen  1
Affiliations

Association Between 18F-FDG PET Activity and HER2 Status in Breast Cancer Brain Metastases

Jonathan R Young et al. Nucl Med Mol Imaging. 2024 May.

Abstract

Purpose: The objective of this study was to evaluate whether uptake on 18F-fluorodeoxyglucose (18F-FDG) PET could help differentiate HER2-positive from HER2-negative breast cancer brain metastases.

Methods: In this retrospective, cross-sectional study of a cohort of 14 histologically proven breast cancer brain metastases, we analyzed both preoperative 18F-FDG PET/CT and HER2 status of the resected/biopsied brain specimens. The maximum standardized uptake values (SUVmax) of the lesions were normalized to contralateral normal white matter and compared using Mann-Whitney U tests.

Results: The study cohort was comprised of 12 women with breast cancer with a mean age of 59 years (range: 43-76 years) with a total of 14 distinct brain metastatic lesions. The SUVmax ratio of HER2-positive breast cancer brain metastases was significantly greater than that of HER2-negative lesions (3.98 vs 1.79, U = 38.00, p = 0.008).

Conclusion: The SUVmax ratio may help to identify the HER2 status of breast cancer brain metastases, if validated prospectively.

Keywords: Brain metastasis; Breast cancer; Maximum standardized uptake; Positron emission tomography.

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Conflict of interest statement

Competing InterestsJonathan R. Young, MD; Julie A. Ressler, MD; Joanne E. Mortimer, MD; Daniel Schmolze, MD; Mariko Fitzgibbons, MD; and Bihong T. Chen, MD, PhD declare no competing interests.

Figures

Fig. 1.
Fig. 1.
18F-FDG PET/CT and contrast-enhanced MRI images of a HER2-positive breast cancer metastasis. Non-contrast CT (A), 18F-FDG PET (B), fused 18F-FDG PET and CT (C), and axial T1-weighted post-contrast (D) images of a HER2-positive breast cancer brain metastasis in a 44-year-old woman. A representative region of interest is shown in white. This lesion had an SUVmax ratio of 4.99. 18F-FDG = 18F-fluorodeoxyglucose. SUVmax = maximum standardized uptake value
Fig. 2.
Fig. 2.
18F-FDG PET/CT and contrast-enhanced MRI images of a HER2-negative breast cancer metastasis. Non-contrast CT (A), 18F-FDG PET (B), fused 18F-FDG PET and CT (C), and axial T1-weighted post-contrast (D) images of a HER2-negative breast cancer brain metastasis in a 68-year-old woman. A representative region of interest is shown in white. This lesion had an SUVmax ratio of 2.19. 18F-FDG = 18F-fluorodeoxyglucose. SUVmax = maximum standardized uptake value
Fig. 3
Fig. 3
SUVmax ratio of HER2-positive and HER2-negative breast cancer brain metastases. Data points are SUVmax ratio values. Error bars are 95% confidence intervals. SUVmax = maximum standardized uptake value. HER2 = human epidermal growth factor receptor 2
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