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

Jonathan R Young; Julie A Ressler; Joanne E Mortimer; Daniel Schmolze; Mariko Fitzgibbons; Bihong T Chen

doi:10.1007/s13139-024-00843-8

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

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

Authors

Jonathan R Young¹, Julie A Ressler¹, Joanne E Mortimer², Daniel Schmolze³, Mariko Fitzgibbons¹, Bihong T Chen¹

Affiliations

¹ Department of Radiology, Division of Neuroradiology, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Rd., Duarte, 91010 CA USA.
² Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Rd., Duarte, 91010 CA USA.
³ Department of Pathology, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Rd, Duarte, 91010 CA USA.

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.