Basal 18 F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography as a prognostic biomarker in patients with locally advanced breast cancer

• Published in: European journal of nuclear medicine and molecular imaging 2015-11, Vol.42 (12), p.1804-1813
• Main Authors: García Vicente, Ana María, Soriano Castrejón, Ángel, López-Fidalgo, Jesús Fernando, Amo-Salas, Mariano, Muñoz Sanchez, María del Mar, Álvarez Cabellos, Ruth, Espinosa Aunión, Ruth
• Format: Article
• Language: English
• Subjects: Cardiology; Imaging; Medicine; Medicine & Public Health; Nuclear Medicine; Oncology; Original Article; Orthopedics; Radiology
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-015-3102-x

Aim To explore the relationship between basal 18  F-FDG PET/CT information in breast tumours and survival in locally advanced breast cancer (LABC). Methods This prospective, multicentre study included 198 women diagnosed with LABC. All patients underwent 18  F-FDG PET/CT prior to treatment. The maximum standardized uptake value (SUVmax) in tumor (T), lymph nodes (N) and the N/T ratio was obtained in all cases. Stage according to PET/CT imaging (metabolic stage) and conventional imaging techniques (clinical stage) was established. During follow-up, patient status was established (disease free status or not). The relationship between all the variables and overall survival (OS) and disease-free survival (DFS) was analysed using the Kaplan-Meier and Cox regression methods. A ROC analysis was performed to obtain a cut-off value of SUVmax that was useful in the prediction of outcome. Results The mean SUVmax ± SD values in the primary tumour, lymph nodes and the SUVmax N/T index were 7.40 ± 5.57, 4.17 ± 4.74 and 0.73 ± 1.20, respectively. Higher semiquantitative metabolic values were found in more advanced metabolic and clinical stages. During follow-up, 78.4 % of patients were free of disease. Significant relationships were observed between SUVT and SUVN and patient status. With respect to OS and DFS, significant differences were detected for the metabolic stage. Kaplan-Meier analysis revealed that using the cut-off values, a primary-tumour SUVmax ≥ 6.05 or a nodal SUVmax ≥2.25 were significantly correlated with DFS and OS. Conclusion PET imaging with 18  F-FDG offers prognostic information for LABC that can be obtained preoperatively and noninvasively