Whole-body (18)F-FDG PET and conventional imaging for predicting outcome in previously treated breast cancer patients.
This study was conducted to determine the ability of (18)F-FDG PET and conventional imaging (CI) to predict the outcomes in breast cancer patients who have previously undergone primary treatment.


METHODS
The study population consisted of 61 female patients (median age, 54 y; range, 32--91 y) who were reevaluated with (18)F-FDG PET and CI after treatment. The median interval between the last treatment and PET was 0.4 y (range, 0--16 y). PET was performed within 3 mo of CI (median interval, 25 d; range, 2--84 d). To determine the independent impact of PET on outcome, PET images were reinterpreted in a blind fashion. Availability of clinical information after PET scanning (21 plus minus 12 mo) was required for study inclusion. Study endpoints were clinical evidence of progression of disease or death.


RESULTS
Of 61 patients, 19 (31.1%) had no clinical evidence and 38 (62.3%) had evidence of residual or recurrent disease by the end of follow-up. Four patients (6.6%) had died. The positive and negative predictive values (PPV and NPV, respectively) of PET were 93% and 84%, respectively. CI yielded a PPV of 85% and an NPV of 59%. The prognostic accuracy of single whole-body PET was superior to that of multiple procedures with CI (90% vs. 75%; P < 0.05). Kaplan--Meier estimates of disease-free survival in patients with negative PET findings compared with those with positive PET findings revealed a significant difference between the 2 curves (log-rank test = 0.001). Kaplan--Meier estimates of disease-free survival stratified by CI results showed a marginally significant difference between CI-positive and CI-negative patients (log-rank test = 0.04).


CONCLUSIONS
FDG PET can be used to improve prediction of the clinical outcome of previously treated breast cancer patients relative to what is achievable through CI alone.
Vranjesevic
Duska
D
Department of Nuclear Medicine, UCLA School of Medicine, Los Angeles, California 90095-6942, USA.
Filmont
Jean Emmanuel
JE
Meta
Joubin
J
Silverman
Daniel H
DH
Phelps
Michael E
ME
Rao
Jyotsna
J
Valk
Peter E
PE
Czernin
Johannes
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed; D016217:Ultrasonography, Mammary
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18