Standardized Uptake Value by Positron Emission Tomography Computed Tomography as A Prognostic Variable in Metastatic Breast Cancer

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1、OriginalArticleStandardizedUptakeValuebyPositronEmissionTomography/ComputedTomographyasAPrognosticVariableinMetastaticBreastCancer12,341,514PatrickG.Morris,MD;GaryA.Ulaner,MD;AnneEaton,MS;MaurizioFazio;KomalJhaveri,MD;SujataPatil,PhD;1,61113LauraEvangelista,MD;JosephY.Park,BS

2、;CristianSerna-Tamayo;JaneHoward;StevenLarson,MD;112CliffordA.Hudis,MD;HeatherL.McArthur,MD;andMaxineS.Jochelson,MDBACKGROUND:Inthisretrospective,single-institutionstudy,theauthorsexaminethemaximumstandardizeduptakevalue(SUVmax)onpositronemissiontomography/computedtomography(

3、PET/CT)imagesasaprognosticvariableinpatientswithnewlydiagnosedmetastaticbreastcancer(MBC).METHODS:Patientswith1metastaticlesiononPET/CTimagesthatwereobtainedwithin60daysoftheirMBCdiagnosisbetweenJanuary1,2001andDecember31,2008wereincluded.Patientswereexcludediftheyhadreceive

4、dchemotherapy30daysbeforethePET/CTimageswereobtained.ElectronicmedicalreportswerereviewedtodeterminetheSUV-maxandoverallsurvival.BecauseofintraindividualvariationintheSUVbybodysite,separateanalyseswereconductedbymeta-staticsite.Relationshipsbetweensite-specificPET/CTvariable

5、tertilesandoverallsurvivalwereassessedusingCoxregression;hazardratiosforthehighesttertileversusthelowesttertilewerereported.RESULTS:Intotal,253patientswereidentified,andtheirmedianagewas57years(range,27-90years).Ofthese,152patients(60%)died,andthemedianfollow-upwas40months.On

6、uni-variateanalysis,SUVmaxtertilewasstronglyassociatedwithoverallsurvivalinpatientswhohadbonemetastases(N?141;hazardratio,3.13;95%confidenceinterval,1.79-5.48;P<.001).Thiseffectwasmaintainedonmultivariateanalysis(HR?3.19;95%confidenceinterval,1.64-6.20,P?.002)aftercorrectingf

7、orknownprognosticvariables.AgreaterriskofdeathwasassociatedwithSUVmaxter-tileinpatientswhohadmetastasestotheliver(N?46;hazardratio,2.07;95%confidenceinterval,0.90-4.76),lymphnodes(N?149;hazardratio,1.1;95%confidenceinterval,0.69-1.88),andlung(N?62;hazardratio,2.2;95%confidenc

8、einterval,0.97-4.95),althoughtheseresultswerenotsignificant(P?.18,P?