Multiparametric imaging with dynamic 18 F-FDG PET shows increased breast glucose metabolism in patients with breast cancer

Purpose Multiparametric PET separates tracer signal into bound and free fractions via reconstructions that reflect the net trapping rate (Ki) and apparent distribution volume (DV). This study aimed to investigate differences in background parenchymal uptake (BPU) between patients with and without breast cancer using multiparametric PET and to evaluate differences in primary tumor uptake according to hormone receptor status. Materials and methods This retrospective case-control study included female patients ( n = 48) with newly diagnosed breast cancer and 146 patients without breast cancer. Patients with breast cancer under or after treatment and patients with bilateral breast cancer were excluded. Enrolled patients underwent whole-body dynamic PET and three quantitative indices representing BPU (maximum standardized uptake value [SUVmax], Ki and DV) were calculated. The primary tumor uptake was calculated between estrogen- or progesterone-receptor-positive and -negative groups. Results The mean SUVmax, Ki and DV of breast cancer cases were 1.39 ± 0.352, 4.88 × 10 − 3 ± 1.61 × 10 − 3 and 24.2 ± 15.4 respectively, whereas in control cases, mean SUVmax, Ki and DV were 1.10 ± 0.320, 3.96 × 10 − 3 ± 1.25 × 10 − 3 and 17.1 ± 10.8 respectively ( P < 0.001, P < 0.001, and P = 0.004). The areas under the curve from the ROC analysis for breast cancer presence were calculated as 0.727, 0.681 and 0.653 respectively. In addition, age-stratified analysis showed that SUVmax and Ki were significantly higher in patients with breast cancer than in patients without breast cancer. Regarding the primary tumor uptake, Ki was significantly higher in the estrogen receptor-positive group. Conclusion Multiparametric PET revealed that pure glucose metabolism is significantly elevated in the background mammary glands of patients with breast cancer, and the Ki in the primary tumor is associated with ER status. Dynamic PET imaging may be a useful imaging biomarker for the development of breast cancer.