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삼중음성 유방암으로 시행한 35세 여성의 수술 전18F-FDG PET/CT 영상. (a,b) 전이 림프절의 PET/CT와 PET 영상에서 높은 FDG 섭취를 확인할 수 있었습니다. (c, d) 이에 반해, 종양의 PET/CT와 PET 영상에서는 중등도의 FDG 섭취가 관찰되었습니다. 수술 9개월 후 뇌 전이가 확인되었으며, 전이 림프절의 대사와 볼륨 인자들이 이를 예측할 수 있었습니다.​

Abstract

PURPOSE:

Triple-negative breast cancer has a poor prognosis. We evaluated several metabolic and volumetric parameters from preoperative 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in the prognosis of triple-negative breast cancer and compared them with current clinicopathologic parameters.

METHODS:

A total of 228 patients with triple-negative breast cancer (mean age 47.0 ± 10.8 years, all women) who had undergone preoperative PET/CT were included. The PET/CT metabolic parameters evaluated included maximum, peak, and mean standardized uptake values (SUVmax, SUVpeak, and SUVmean, respectively). The volumetric parameters evaluated included metabolic tumor volume (MTV) and total lesion glycolysis (TLG). Metabolic and volumetric parameters were evaluated separately for tumor (T) and lymph nodes (N). The prognostic value of these parameters was compared with that of clinicopathologic parameters.

RESULTS:

All lymph node metabolic and volumetric parameters showed significant differences between patients with and without recurrence. However, tumor metabolic and volumetric parameters showed no significant differences. In a univariate survival analysis, all lymph node metabolic and volumetric parameters (SUVmax-N, SUVpeak-N, SUVmean-N, MTV-N, and TLG-N; all P < 0.001), T stage (P = 0.010), N stage (P < 0.001), and TNM stage (P < 0.001) were significant parameters. In a multivariate survival analysis, SUVmax-N (P = 0.005), MTV (P = 0.008), and TLG (P = 0.006) with TNM stage (all P < 0.001) were significant parameters.

CONCLUSIONS:

Lymph node metabolic and volumetric parameters were significant predictors of recurrence in patients with triple-negative breast cancer after surgery. Lymph node metabolic and volumetric parameters were useful parameters for evaluating prognosis in patients with triple-negative breast cancer by 18F-FDG PET/CT, rather than tumor parameters.\

Author information

Kim YI1,2, Kim YJ3, Paeng JC2, Cheon GJ2, Lee DS2, Chung JK2,4, Kang KW5,6,7,8.

1 Department of Nuclear Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.

2 Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea.

3 Veterans Health Service Medical Center, Seoul, Korea.

4 Cancer Research Institute, Seoul National University, Seoul, Korea.

5 Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea. kangkw@snu.ac.kr.

6 Cancer Research Institute, Seoul National University, Seoul, Korea. kangkw@snu.ac.kr.

7 Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea. kangkw@snu.ac.kr.

8 Department of Nuclear Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Chongno-gu, Seoul, 03080, Korea. kangkw@snu.ac.kr.