DOI: 10.1007/s00259-017-3770-9Pages: 1945-1954

[18F]FDG PET/CT features for the molecular characterization of primary breast tumors

1. Humanitas Research Hospital, Nuclear Medicine Department

2. National Research Council, Laboratory of Innovation and Integration in Molecular Medicine, Institute of Molecular Bioimaging and Physiology

3. Humanitas University, Department of Biomedical Sciences

4. Humanitas Research Hospital, Breast Unit

5. Integrated University Hospital, Breast Unit

6. University of Milan, Residency Program in Nuclear Medicine

Correspondence to:
Arturo Chiti
Tel: +39 02 8224 6621




The aim of this study was to evaluate the role of imaging features derived from [18F]FDG-PET/CT to provide in vivo characterization of breast cancer (BC).


Images from 43 patients with a first diagnosis of BC were reviewed. Images were acquired before any treatment. Histological data were derived from pretreatment biopsy or surgical histological specimen; these included tumor type, grade, ER and PgR receptor status, lymphovascular invasion, Ki67 index, HER2 status, and molecular subtype. Standard parameters (SUVmean, TLG, MTV) and advanced imaging features (histogram-based and shape and size features) were evaluated. Univariate analysis, hierarchical clustering analysis, and exact Fisher’s test were used for statistical analysis of data. Imaging-derived metrics were reduced evaluating the mutual correlation within group of features as well as the mutual correlation between groups of features to form a signature.


A significant correlation was found between some advanced imaging features and the histological type. Different molecular subtypes were characterized by different values of two histogram-based features (median and energy). A significant association was observed between the imaging signature and luminal A and luminal B HER2 negative molecular subtype and also when considering luminal A, luminal B HER2-negative and HER2-positive groups. Similar results were found between the signature and all five molecular subtypes and also when considering the histological types of BC.


Our results suggest a complementary role of standard PET imaging parameters and advanced imaging features for the in vivo biological characterization of BC lesions.

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  • Accepted: Jun 28, 2017
  • Online: Jul 15, 2017

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