Kitajima Kazuhiro, Miyoshi Yasuo, Yamano Toshiko, Odawara Soichi, Higuchi Tomoko, Yamakado Koichiro
Division of Nuclear Medicine and PET center, Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
Department of Breast and Endocrine Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
Ann Nucl Med. 2018 Jan;32(1):44-53. doi: 10.1007/s12149-017-1217-9. Epub 2017 Nov 13.
To investigate the prognostic value of preoperative FDG-PET/CT and diffusion weighted imaging (DWI) in patients with breast cancer.
A total of 73 patients with newly diagnosed invasive breast cancer who had undergone preoperative whole-body FDG-PET/CT and 3-Tesla breast MRI including DWI followed by surgery were identified. Effects of primary tumor PET parameters [maximum standardized uptake value (SUV), mean SUV (SUV), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)] and DWI parameters [mean apparent diffusion coefficient (ADC) and minimum ADC (ADC)] including clinicopathologic factors on disease-free survival (DFS) were retrospectively evaluated using the log-rank and Cox methods.
After a median overall follow-up of 32.3 months in all patients, 6 (8.2%) of the 73 patients had recurrence. Receiver operating characteristic curve analysis and log-rank tests showed that patients with a high primary tumor SUV (≥ 3.60), MTV (≥ 3.15), and TLG (≥ 16.0) had a significantly lower DFS rate than those with a low SUV (< 3.60), MTV (< 3.15), and TLG (< 16.0), respectively (p = 0.0054, p = 0.0054, and p < 0.0001, respectively). SUV, ADC, and ADC were not significantly associated with recurrence. Univariate analysis showed that SUV (p = 0.0054), MTV (p = 0.0054), TLG (p < 0.0001), tumor size (p = 0.0083), estrogen receptor negativity (p = 0.046), progesterone receptor negativity (p = 0.0023), human epidermal growth factor receptor 2 positivity (p = 0.043), and the presence of axillary lymph node metastasis (p = 0.0037) were also significantly associated with recurrence. However, in multivariate analysis, none of them were an independent factor.
The preoperative SUV, MTV, and TLG of primary breast cancer are prognostic factors for recurrence, whereas ADC values are not.
探讨术前氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）及扩散加权成像（DWI）对乳腺癌患者的预后价值。
共纳入73例新诊断的浸润性乳腺癌患者，这些患者均接受了术前全身FDG-PET/CT及3特斯拉乳腺磁共振成像（包括DWI）检查，随后接受了手术。采用对数秩检验和Cox方法回顾性评估原发性肿瘤PET参数[最大标准化摄取值（SUV）、平均SUV（SUV）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）]及DWI参数[平均表观扩散系数（ADC）和最小ADC（ADC）]，以及临床病理因素对无病生存期（DFS）的影响。
所有患者的中位总随访时间为32.3个月，73例患者中有6例（8.2%）复发。受试者工作特征曲线分析和对数秩检验显示，原发性肿瘤SUV高（≥3.60）、MTV高（≥3.15）和TLG高（≥16.0）的患者DFS率分别显著低于SUV低（<3.60）、MTV低（<3.15）和TLG低（<16.0）的患者（p分别为0.0054、0.0054和<0.0001）。SUV、ADC和ADC与复发无显著相关性。单因素分析显示，SUV（p=0.0054）、MTV（p=0.0054）、TLG（p<0.0001）、肿瘤大小（p=0.0083）、雌激素受体阴性（p=0.046）、孕激素受体阴性（p=0.0023）、人表皮生长因子受体2阳性（p=0.043）及腋窝淋巴结转移的存在（p=0.0037）也与复发显著相关。然而，多因素分析显示，它们均不是独立因素。
原发性乳腺癌术前SUV、MTV和TLG是复发的预后因素，而ADC值不是。
