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Nuclear Medicine |
1 From the Department of Nuclear Medicine (U.T., C.G., H.W.D.Y., H.A.M.) and Division of Breast Medical Oncology (S.D., M.C.), University of Texas M.D. Anderson Cancer Center, Unit 1263, 1515 Holcombe Blvd, Houston, TX 77030. Received March 27, 2007; revision requested May 25; revision received May 31; accepted June 14; final version accepted September 17. Supported in part by grants from Scientific Research Expenses for Health and Welfare Programs and the Grant-in-Aid for Cancer Research from the Ministry of Health, Labor, and Welfare. Address correspondence to U.T. (e-mail: utateish{at}ncc.go.jp).
Purpose: To retrospectively compare morphologic and metabolic changes in bone metastases in response to systemic therapy in patients with metastatic breast cancer (MBC) with integrated positron emission tomography (PET)/computed tomography (CT).
Materials and Methods: The institutional review board waived the requirement for informed consent and approved this HIPAA-compliant study. A retrospective analysis was performed with 102 women (mean age, 55 years) with MBC who received systemic treatment. All patients underwent integrated PET/CT before and after treatment. Two reviewers analyzed the images in consensus. Morphologic changes, including morphologic patterns, and lesion attenuation were evaluated. Standardized uptake value (SUV) and total lesion glycolysis (TLG) were analyzed to evaluate metabolic changes. Uni- and multivariate analyses were performed to identify factors that enabled response duration (RD) to be predicted.
Results: At baseline, the morphologic patterns of the target lesions were lytic (n = 33), sclerotic (n = 22), mixed (n = 42), and unclassified (n = 5). Progression of sclerotic change after treatment was identified in 49 patients (48%). After treatment, the mean attenuation of the lesion increased, whereas the mean SUV and TLG decreased. Increases in attenuation correlated significantly with decreases in SUV (r = –0.510, P < .001) and TLG (r = –0.491, P < . 001). Univariate analysis revealed that the increase in attenuation and the decrease in SUV were potential predictors of RD. Multivariate analysis revealed that an increase in the change in SUV was a significant predictor of RD (relative risk, 2.4; P = .003).
Conclusion: A decrease in SUV after treatment was an independent predictor of RD in patients with MBC who had bone metastases.
© RSNA, 2008
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