title: Whole-body total lesion glycolysis measured on fluorodeoxyglucose positron emission tomography/computed tomography as a prognostic variable in metastatic breast cancer.
abstract: BACKGROUND
  In this retrospective study, the authors evaluated the prognostic value of whole-body total lesion glycolysis (WTLG) on FDG/PET images in metastatic breast cancer (MBC) patients.
  
  
  METHODS
  We retrospectively evaluated 54 MBC patients who were diagnosed as having one or more metastatic lesions between June 2005 and March 2013. Twenty-four patients were diagnosed at the initial presentation (group A) and 30 patients were diagnosed for the first time at some point after a surgery (group B). Patients were excluded if they had received chemotherapy within 30 days before PET/CT. SUVmax and total TLG were calculated for all lesions in each patient and the highest SUVmax and the whole-body TLG (WTLG) values were used as independent variables for the analyses. Mean ages and the proportions of histopathological subtypes were compared between two groups using Mann-Whitney U test and Fisher's exact test, respectively. The prognostic significance of PET parameters was assessed using Cox proportional hazards regression analysis.
  
  
  RESULTS
  For groups A and B, the median follow-up period was 26 months (range, 3-58 months) and 40.5 months (range, 3-69 months), and the median age was 61 years (range, 42-81 years) and 59 years (range, 24-74 years), respectively. There were no significant differences between two groups in age (p = 0.294) or histopathological subtype (p = 0.384). In the univariate analyses, WTLG was found to be significantly associated with overall survival (OS) for patients of group A (p = 0.012). In the multivariate analysis, WTLG was also significantly associated with OS (p = 0.015). Only hormonal receptor level was a significant indicator of longer OS in patients with recurrent MBC (group B).
  
  
  CONCLUSIONS
  This study demonstrated that WTLG on PET/CT is an independent prognostic factor for survival in breast cancer patients with metastases at the initial presentation.
authors.affiliation: PET Center, Kofu Neurosurgical Hospital, Sakaori 1-16-18, Kofu City, Yamanashi Prefecture, Japan. pecampecam@yahoo.co.jp.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Satoh
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nambu
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Onishi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000175:diagnosis* / Q000473:pathology; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012044:Regression Analysis; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18