Prognostic value of quantitative fluorodeoxyglucose measurements in newly diagnosed metastatic breast cancer Journal Article


Authors: Ulaner, G. A.; Eaton, A.; Morris, P. G.; Lilienstein, J.; Jhaveri, K.; Patil, S.; Fazio, M.; Larson, S.; Hudis, C. A.; Jochelson, M. S.
Article Title: Prognostic value of quantitative fluorodeoxyglucose measurements in newly diagnosed metastatic breast cancer
Abstract: The aim of this study was to determine the prognostic value of quantitative fluorodeoxyglucose (FDG) measurements (maximum standardized uptake value [SUVmax], metabolic tumor volume [MTV], and total lesion glycolysis [TLG]) in patients with newly diagnosed metastatic breast cancer (MBC). An IRB-approved retrospective review was performed of patients who underwent FDG positron emission tomography (PET)/computed tomography (CT) from 1/02 to 12/08 within 60 days of diagnosis MBC. Patients with FDG-avid lesions without receiving chemotherapy in the prior 30 days were included. Target lesions in bone, lymph node (LN), liver, and lung were analyzed for SUVmax, MTV, and TLG. Medical records were reviewed for patient characteristics and overall survival (OS). Cox regression was used to test associations between quantitative FDG measurements and OS. A total of 253 patients were identified with disease in bone (n = 150), LN (n = 162), liver (n = 48), and lung (n = 66) at the time of metastatic diagnosis. Higher SUVmax tertile was associated with worse OS in bone metastases (highest vs. lowest tertile hazard ratio [HR] = 3.1, P < 0.01), but not in LN, liver or lung (all P > 0.1). Higher MTV tertile was associated with worse OS in LN (HR = 2.4, P < 0.01) and liver (HR = 3.0, P = 0.02) metastases, but not in bone (P = 0.22) or lung (P = 0.14). Higher TLG tertile was associated with worse OS in bone (HR = 2.2, P = 0.02), LN (HR = 2.3, P < 0.01), and liver (HR = 4.9, P < 0.01) metastases, but not in lung (P = 0.19). We conclude measures of FDG avidity are prognostic biomarkers in newly diagnosed MBC. SUVmax and TLG were both predictors of survival in breast cancer patients with bone metastases. TLG may be a more informative biomarker of OS than SUVmax for patients with LN and liver metastases. © 2013 The Authors.
Keywords: adult; aged; aged, 80 and over; bone neoplasms; middle aged; retrospective studies; liver neoplasms; lymphatic metastasis; sensitivity and specificity; radiopharmaceuticals; breast cancer; lung neoplasms; breast neoplasms; tumor burden; fluorodeoxyglucose f18; positron-emission tomography; fdg pet/ct; glycolysis; kaplan-meier estimate; total lesion glycolysis; humans; prognosis; female; mean tumor volume; suv max
Journal Title: Cancer Medicine
Volume: 2
Issue: 5
ISSN: 2045-7634
Publisher: Wiley Blackwell  
Date Published: 2013-10-01
Start Page: 725
End Page: 733
Language: English
DOI: 10.1002/cam4.119
PUBMED: 24403238
PROVIDER: scopus
PMCID: PMC3892804
DOI/URL:
Notes: Article -- Export Date: 5 June 2017 -- Source: Scopus
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MSK Authors
  1. Sujata Patil
    511 Patil
  2. Patrick Glyn Morris
    116 Morris
  3. Gary Ulaner
    146 Ulaner
  4. Clifford Hudis
    905 Hudis
  5. Maxine Jochelson
    134 Jochelson
  6. Komal Lachhman Jhaveri
    202 Jhaveri
  7. Anne Austin Eaton
    122 Eaton
  8. Steven M Larson
    959 Larson
  9. Maurizio Fazio
    5 Fazio