18F-FDG PET/CT Semiquantitative and Radiomic Features for Assessing Pathologic Axillary Lymph Node Status in Clinical Stage I–III Breast Cancer Patients: A Systematic Review
<b>Purpose:</b> To investigate associations between 18F-FDG-PET/CT semiquantitative and radiomic features with pathologic axillary lymph node (ALN) status in stages I–III breast cancer patients. <b>Methods:</b> A search was conducted across MEDLINE, EMBASE, and CENTRAL databa...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-05-01
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| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/32/6/300 |
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| Summary: | <b>Purpose:</b> To investigate associations between 18F-FDG-PET/CT semiquantitative and radiomic features with pathologic axillary lymph node (ALN) status in stages I–III breast cancer patients. <b>Methods:</b> A search was conducted across MEDLINE, EMBASE, and CENTRAL databases. Quality assessment was performed with QUADAS-2 and the radiomics quality score (RQS). Descriptive statistical analysis was performed. <b>Results:</b> Most studies were retrospective cohort studies (27/28) and reported only on semiquantitative features (26/28). Most studies were at high risk of bias in patient selection (22/28) and feature extraction (26/28). Semiquantitative features included maximum standardized uptake value (SUVmax), metabolic tumour volume (MTV), and total lesion glycolysis (TLG). Although associations between tumour semiquantitative features and ALN status were reported, the mean/median reported values of tumour SUVmax (3.2–8.6 vs. 2.4–9.4), MTV (2.7–19.2 vs. 1.9–10.5), and TLG (10.6–59.3 vs. 5.6–29.6) in ALN+ vs. ALN− patients were inconsistent between studies. Fourteen studies reported a significantly higher ALN SUVmax in ALN+ patients. Two studies developed models using tumour radiomic features with high accuracy for predicting ALN metastases (81.2% and 80%) but scored low on the RQS. <b>Conclusions:</b> Feature-based analysis of PET/CT demonstrates potential for predicting pathologic ALN status in breast cancer patients. However, establishing a clinically meaningful relationship requires higher quality evidence. |
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| ISSN: | 1198-0052 1718-7729 |