Prognostic Value of Percentage Change in Metabolic Parameters as Measured by Dual-Time Point 18F-FDG PET/CT in Premenopausal Women with Invasive Ductal Breast Carcinoma

Abstract

Objectives: We retrospectively evaluated the prognostic significance of dual-time point (DTP) 18F-FDG positron emission tomography/computed tomography (PET/CT) parameters compared with clinicopathological findings in premenopausal women with invasive ductal breast carcinoma (IDC). Materials and Methods: Sixty-six premenopausal women (mean age: 42.7 ± 5.6, range: 29.5-51.8 years) who had pathologically confirmed IDC were enrolled. The maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured and used to calculate percentage changes over the DTP time interval. We analyzed the prognostic significance of DTP PET/CT parameters, clinicopathological factors of pathologic tumor diameter (pTD), axillary lymph node status (ANS), nuclear grade, histologic grade, and immunohistochemistry findings using univariate and multivariate analyses. Results: Disease recurrence was observed in 22 patients. In univariate analysis, SUVmax > 7.39, MTV > 4.28, TLG > 52.38, %ΔSUVmax > 20.44, %ΔTLG >-13.86, pTD > 2.8 cm, positive ANS, estrogen receptor (ER) negativity, and triple negativity were associated with worse prognosis than those of opposite groups in recurrence-free survival (all p < 0.05). %ΔSUVmax (>20.44, p = 0.0042), TLG (>52.38, p = 0.0002), and ER negativity (p = 0.0003) were independent prognostic variables after multivariate analysis. Conclusion: Percentage changes in SUVmax using DTP PET/CT and TLG were significant independent prognostic factors of disease recurrence along with ER negativity in premenopausal women with IDC. © 2017, Mary Ann Liebert, Inc.