Bouron Clément, Mathie Clara, Seegers Valérie, Morel Olivier, Jézéquel Pascal, Lasla Hamza, Guillerminet Camille, Girault Sylvie, Lacombe Marie, Sher Avigaelle, Lacoeuille Franck, Patsouris Anne, Testard Aude
Department of Nuclear Medicine, ICO Pays de la Loire, 15 rue André Boquel, 49055 Angers, France.
Department of Nuclear Medicine, University Hospital of Angers, 4 rue Larrey, 49100 Angers, France.
Cancers (Basel). 2022 Jan 27;14(3):637. doi: 10.3390/cancers14030637.
(1) Background: triple-negative breast cancer (TNBC) remains a clinical and therapeutic challenge primarily affecting young women with poor prognosis. TNBC is currently treated as a single entity but presents a very diverse profile in terms of prognosis and response to treatment. Positron emission tomography/computed tomography (PET/CT) with F-fluorodeoxyglucose ([F]FDG) is gaining importance for the staging of breast cancers. TNBCs often show high [F]FDG uptake and some studies have suggested a prognostic value for metabolic and volumetric parameters, but no study to our knowledge has examined textural features in TNBC. The objective of this study was to evaluate the association between metabolic, volumetric and textural parameters measured at the initial [F]FDG PET/CT and disease-free survival (DFS) and overall survival (OS) in patients with nonmetastatic TBNC. (2) Methods: all consecutive nonmetastatic TNBC patients who underwent a [F]FDG PET/CT examination upon diagnosis between 2012 and 2018 were retrospectively included. The metabolic and volumetric parameters (SUV, SUV, SUV, MTV, and TLG) and the textural features (entropy, homogeneity, SRE, LRE, LGZE, and HGZE) of the primary tumor were collected. (3) Results: 111 patients were enrolled (median follow-up: 53.6 months). In the univariate analysis, high TLG, MTV and entropy values of the primary tumor were associated with lower DFS ( = 0.008, = 0.006 and = 0.025, respectively) and lower OS ( = 0.002, = 0.001 and = 0.046, respectively). The discriminating thresholds for two-year DFS were calculated as 7.5 for MTV, 55.8 for TLG and 2.6 for entropy. The discriminating thresholds for two-year OS were calculated as 9.3 for MTV, 57.4 for TLG and 2.67 for entropy. In the multivariate analysis, lymph node involvement in PET/CT was associated with lower DFS ( = 0.036), and the high MTV of the primary tumor was correlated with lower OS ( = 0.014). (4) Conclusions: textural features associated with metabolic and volumetric parameters of baseline [F]FDG PET/CT have a prognostic value for identifying high-relapse-risk groups in early TNBC patients.
(1) 背景：三阴性乳腺癌（TNBC）仍然是一项临床和治疗挑战，主要影响预后较差的年轻女性。TNBC目前被视为一个单一实体，但在预后和对治疗的反应方面呈现出非常多样化的特征。使用F-氟脱氧葡萄糖（[F]FDG）的正电子发射断层扫描/计算机断层扫描（PET/CT）在乳腺癌分期中越来越重要。TNBC通常表现出高[F]FDG摄取，一些研究表明代谢和体积参数具有预后价值，但据我们所知，尚无研究检查TNBC的纹理特征。本研究的目的是评估在初始[F]FDG PET/CT测量的代谢、体积和纹理参数与非转移性TBNC患者的无病生存期（DFS）和总生存期（OS）之间的关联。(2) 方法：回顾性纳入2012年至2018年间所有在诊断时接受[F]FDG PET/CT检查的连续非转移性TNBC患者。收集原发肿瘤的代谢和体积参数（SUV、SUV、SUV、MTV和TLG）以及纹理特征（熵、均匀性、SRE、LRE、LGZE和HGZE）。(3) 结果：共纳入111例患者（中位随访时间：53.6个月）。在单因素分析中，原发肿瘤的高TLG、MTV和熵值与较低的DFS（分别为 = 0.008、 = 0.006和 = 0.025）和较低的OS（分别为 = 0.002、 = 0.001和 = 0.046）相关。两年DFS的鉴别阈值计算为MTV为7.5、TLG为55.8、熵为2.6。两年OS的鉴别阈值计算为MTV为9.3、TLG为57.4、熵为2.67。在多因素分析中，PET/CT中的淋巴结受累与较低的DFS相关（ = 0.036），原发肿瘤的高MTV与较低的OS相关（ = 0.014）。(4) 结论：与基线[F]FDG PET/CT的代谢和体积参数相关的纹理特征对识别早期TNBC患者中的高复发风险组具有预后价值。
