Quantitative assessment of volume-based metabolic parameters in early-stage invasive ductal breast cancer: Impact of different standardized uptake value thresholds on prognostic factors - A comprehensive analysis.

Objective: This study compares volume-based metabolic parameters in early-stage invasive ductal breast cancer using different standardized uptake value (SUV) thresholds and examines their association with immunohistochemical factors.

Subjects and methods: A retrospective analysis included 135 patients with early-stage invasive ductal breast cancer who underwent preoperative fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) scans. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were derived using absolute SUV threshold methods and fixed % maximum tumor SUV threshold methods. Associations with immunohistochemical factors were explored, and receiver operating characteristic curves were generated.

Results: Metabolic tumor volume 2.5 and TLG 2.5 showed stronger correlations with maximum tumor SUV values. Metabolic tumor volume 2.0 and TLG 2.0 had superior area under the curve (AUC) values in predicting estrogen and progesterone receptor negativity. Metabolic tumor volume 2.0 and TLG 2.0 were superior in distinguishing low and high-grade tumors.

Conclusion: Absolute SUV threshold methods with a threshold of 2.0 are recommended for calculating volume-based metabolic parameters due to their strong correlation with immunohistochemical factors in invasive ductal breast cancer.