Nucl Med Mol Imaging.  2012 Dec;46(4):278-285.

Prognostic Significance of Metabolic Tumor Volume Measured by 18F-FDG PET/CT in Operable Primary Breast Cancer

Affiliations
  • 1Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, 42 Jebong-no, Donggu, Gwangju 501-757, Republic of Korea. songhc@jnu.ac.kr
  • 2Department of Surgery, Chonnam National University Medical School, 42 Jebong-no, Donggu, Gwangju, Republic of Korea.

Abstract

PURPOSE
We investigated whether PET indices measured by 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) can predict prognosis in patients with operable primary breast cancer.
METHODS
We reviewed 53 patients with operable primary breast cancer who underwent pretreatment FDG PET/CT. PET indices, maximum standardized uptake value (SUV) and metabolic tumor volume (MTV), were measured in the primary breast tumor (P), metastatic lymph nodes (N) and total tumor (T). The Cox proportional hazards model was used with age, tumor size, clinical lymph node status, method of surgery, presence or absence of neoadjuvant chemotherapy, histological type, histological grade, hormone receptors and HER2 status to predict disease-free survival (DFS) and overall survival (OS).
RESULTS
Median follow-up period was 50 months (range, 17-73 months), during which 17 patients had recurrent disease and nine of whom died. The univariate analysis showed that high SUV of N (NSUV, P=0.011), MTV of N (NMTV, P=0.011) and MTV of T (TMTV, P=0.045) as well as high histological grade (P=0.008), negative estrogen (P=0.045) and negative progesterone (P=0.029) receptor status were associated with shorter DFS. High NSUV (P=0.035), NMTV (P=0.035) and TMTV (P=0.035) as well as high histological grade (P=0.012) and negative estrogen receptor status (P=0.009)were associatedwith shorterOS. NSUV, NMTV and TMTV were found to be significantly associatedwith high histological grade (P=0.005). However, those failed to be statistically significant prognostic factors on multivariate analysis.
CONCLUSIONS
PET indices seem to be useful in the preoperative evaluation of prognosis in patients with operable primary breast cancer. NSUV, NMTV and TMTV might be considerable factors associated with patient outcome in operable breast cancer.

Keyword

Breast cancer; FDG PET/CT; Maximum standardized uptake value; Metabolic tumor volume; Prognosis

MeSH Terms

Breast
Breast Neoplasms
Disease-Free Survival
Electrons
Estrogens
Fluorodeoxyglucose F18
Follow-Up Studies
Humans
Lymph Nodes
Progesterone
Prognosis
Proportional Hazards Models
Tumor Burden
Estrogens
Fluorodeoxyglucose F18
Progesterone
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