The utility of 18 F-FDG PET/CT for suspected recurrent breast cancer: impact and prognostic stratification
Identifieur interne : 001489 ( Pmc/Curation ); précédent : 001488; suivant : 001490The utility of 18 F-FDG PET/CT for suspected recurrent breast cancer: impact and prognostic stratification
Auteurs : Alexandre Cochet [Australie, France] ; Steven David [Australie] ; Kate Moodie [Australie] ; Elizabeth Drummond [Australie] ; Gaelle Dutu [Australie] ; Michael Macmanus [Australie] ; Boon Chua [Australie] ; Rodney J. Hicks [Australie]Source :
- Cancer Imaging [ 1740-5025 ] ; 2014.
Abstract
The incremental value of 18FDG PET/CT in patients with breast cancer (BC) compared to conventional imaging (CI) in clinical practice is unclear. The aim of this study was to evaluate the management impact and prognostic value of 18 F-FDG PET/CT in this setting.
Sixty-three patients who were referred to our institution for suspicion of BC relapse were retrospectively enrolled. All patients had been evaluated with CI and underwent PET/CT. At a median follow-up of 61 months, serial clinical, imaging and pathologic results were obtained to validate diagnostic findings. Overall Survival (OS) was estimated using Kaplan Meier methods and analyzed using the Cox proportional hazards regression models.
Forty-two patients had a confirmed relapse with 37 (88%) positive on CI and 40 (95%) positive on PET/CT. When compared with CI, PET/CT had a higher negative predictive value (86% versus 54%) and positive predictive value (95% versus 70%). The management impact of PET/CT was high (change of treatment modality or intent) in 30 patients (48%) and medium (change in radiation treatment volume or dose fractionation) in 6 patients (9%). Thirty-nine patients (62%) died during follow-up. The PET/CT result was a highly significant predictor of OS (Hazard Ratio [95% Confidence Interval] =4.7 [2.0-10.9] for PET positive versus PET negative for a systemic recurrence; p = 0.0003). In a Cox multivariate analysis including other prognosis factors, PET/CT findings predicted survival (p = 0.005). In contrast, restaging by CI was not significant predictor of survival.
Our study support the value of 18 F-FDG PET/CT in providing incremental information that influence patient management and refine prognostic stratification in the setting of suspected recurrent breast cancer.
Url:
DOI: 10.1186/1470-7330-14-13
PubMed: 25608599
PubMed Central: 4331819
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Hicks</name><affiliation wicri:level="1"><nlm:aff id="I1">Centre for Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Centre for Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">The Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>The Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25608599</idno><idno type="pmc">4331819</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4331819</idno><idno type="RBID">PMC:4331819</idno><idno type="doi">10.1186/1470-7330-14-13</idno><date when="2014">2014</date><idno 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Nuclear Medicine, Centre Georges-François Leclerc, 1 rue Professeur Marion, Dijon Cedex 21079, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Nuclear Medicine, Centre Georges-François Leclerc, 1 rue Professeur Marion, Dijon Cedex 21079</wicri:regionArea></affiliation></author><author><name sortKey="David, Steven" sort="David, Steven" uniqKey="David S" first="Steven" last="David">Steven David</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">The Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>The Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville</wicri:regionArea></affiliation></author><author><name sortKey="Moodie, Kate" sort="Moodie, Kate" uniqKey="Moodie K" first="Kate" last="Moodie">Kate Moodie</name><affiliation wicri:level="1"><nlm:aff id="I1">Centre for Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Centre for Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne</wicri:regionArea></affiliation></author><author><name sortKey="Drummond, Elizabeth" sort="Drummond, Elizabeth" uniqKey="Drummond E" first="Elizabeth" last="Drummond">Elizabeth Drummond</name><affiliation wicri:level="1"><nlm:aff id="I1">Centre for Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Centre for Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">The Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>The Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville</wicri:regionArea></affiliation></author><author><name sortKey="Dutu, Gaelle" sort="Dutu, Gaelle" uniqKey="Dutu G" first="Gaelle" last="Dutu">Gaelle Dutu</name><affiliation wicri:level="1"><nlm:aff id="I3">Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, East Melbourne, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, East Melbourne</wicri:regionArea></affiliation></author><author><name sortKey="Macmanus, Michael" sort="Macmanus, Michael" uniqKey="Macmanus M" first="Michael" last="Macmanus">Michael Macmanus</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">The Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>The Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville</wicri:regionArea></affiliation></author><author><name sortKey="Chua, Boon" sort="Chua, Boon" uniqKey="Chua B" first="Boon" last="Chua">Boon Chua</name><affiliation wicri:level="1"><nlm:aff id="I2">Department of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">The Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>The Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville</wicri:regionArea></affiliation></author><author><name sortKey="Hicks, Rodney J" sort="Hicks, Rodney J" uniqKey="Hicks R" first="Rodney J" last="Hicks">Rodney J. Hicks</name><affiliation wicri:level="1"><nlm:aff id="I1">Centre for Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Centre for Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">The Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>The Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville</wicri:regionArea></affiliation></author></analytic><series><title level="j">Cancer Imaging</title><idno type="ISSN">1740-5025</idno><idno type="eISSN">1470-7330</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The incremental value of <sup>18</sup>FDG PET/CT in patients with breast cancer (BC) compared to conventional imaging (CI) in clinical practice is unclear. The aim of this study was to evaluate the management impact and prognostic value of <sup>18</sup> F-FDG PET/CT in this setting.</p></sec><sec><title>Methods</title><p>Sixty-three patients who were referred to our institution for suspicion of BC relapse were retrospectively enrolled. All patients had been evaluated with CI and underwent PET/CT. At a median follow-up of 61 months, serial clinical, imaging and pathologic results were obtained to validate diagnostic findings. Overall Survival (OS) was estimated using Kaplan Meier methods and analyzed using the Cox proportional hazards regression models.</p></sec><sec><title>Results</title><p>Forty-two patients had a confirmed relapse with 37 (88%) positive on CI and 40 (95%) positive on PET/CT. When compared with CI, PET/CT had a higher negative predictive value (86% versus 54%) and positive predictive value (95% versus 70%). The management impact of PET/CT was high (change of treatment modality or intent) in 30 patients (48%) and medium (change in radiation treatment volume or dose fractionation) in 6 patients (9%). Thirty-nine patients (62%) died during follow-up. The PET/CT result was a highly significant predictor of OS (Hazard Ratio [95% Confidence Interval] =4.7 [2.0-10.9] for PET positive versus PET negative for a systemic recurrence; p = 0.0003). In a Cox multivariate analysis including other prognosis factors, PET/CT findings predicted survival (p = 0.005). In contrast, restaging by CI was not significant predictor of survival.</p></sec><sec><title>Conclusion</title><p>Our study support the value of <sup>18</sup> F-FDG PET/CT in providing incremental information that influence patient management and refine prognostic stratification in the setting of suspected recurrent breast cancer.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Van Dongen, Ja" uniqKey="Van Dongen J">JA van Dongen</name></author><author><name sortKey="Voogd, Ac" uniqKey="Voogd A">AC Voogd</name></author><author><name sortKey="Fentiman, Is" uniqKey="Fentiman I">IS Fentiman</name></author><author><name sortKey="Legrand, C" uniqKey="Legrand C">C Legrand</name></author><author><name sortKey="Sylvester, Rj" uniqKey="Sylvester R">RJ Sylvester</name></author><author><name sortKey="Tong, D" uniqKey="Tong D">D Tong</name></author><author><name sortKey="Van Der Schueren, E" uniqKey="Van Der Schueren E">E van der 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Cancer Imaging</journal-id><journal-id journal-id-type="iso-abbrev">Cancer Imaging</journal-id><journal-title-group><journal-title>Cancer Imaging</journal-title></journal-title-group><issn pub-type="ppub">1740-5025</issn><issn pub-type="epub">1470-7330</issn><publisher><publisher-name>BioMed Central</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25608599</article-id><article-id pub-id-type="pmc">4331819</article-id><article-id pub-id-type="publisher-id">1470-7330-14-13</article-id><article-id pub-id-type="doi">10.1186/1470-7330-14-13</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>The utility of <sup>18</sup> F-FDG PET/CT for suspected recurrent breast cancer: impact and prognostic stratification</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes" id="A1"><name><surname>Cochet</surname><given-names>Alexandre</given-names></name><xref ref-type="aff" rid="I1">1</xref><xref ref-type="aff" rid="I5">5</xref><email>ACochet@dijon.fnclcc.fr</email></contrib><contrib contrib-type="author" id="A2"><name><surname>David</surname><given-names>Steven</given-names></name><xref ref-type="aff" rid="I2">2</xref><xref ref-type="aff" rid="I4">4</xref><email>steve.david@petermac.org</email></contrib><contrib contrib-type="author" id="A3"><name><surname>Moodie</surname><given-names>Kate</given-names></name><xref ref-type="aff" rid="I1">1</xref><email>kate.moodie@petermac.org</email></contrib><contrib contrib-type="author" id="A4"><name><surname>Drummond</surname><given-names>Elizabeth</given-names></name><xref ref-type="aff" rid="I1">1</xref><xref ref-type="aff" rid="I4">4</xref><email>elizabeth.drummond@petermac.org</email></contrib><contrib contrib-type="author" id="A5"><name><surname>Dutu</surname><given-names>Gaelle</given-names></name><xref ref-type="aff" rid="I3">3</xref><email>gaelle.dutu@petermac.org</email></contrib><contrib contrib-type="author" id="A6"><name><surname>MacManus</surname><given-names>Michael</given-names></name><xref ref-type="aff" rid="I2">2</xref><xref ref-type="aff" rid="I4">4</xref><email>michael.macmanus@petermac.org</email></contrib><contrib contrib-type="author" id="A7"><name><surname>Chua</surname><given-names>Boon</given-names></name><xref ref-type="aff" rid="I2">2</xref><xref ref-type="aff" rid="I4">4</xref><email>boon.chua@petermac.org</email></contrib><contrib contrib-type="author" id="A8"><name><surname>Hicks</surname><given-names>Rodney J</given-names></name><xref ref-type="aff" rid="I1">1</xref><xref ref-type="aff" rid="I4">4</xref><email>rod.hicks@petermac.org</email></contrib></contrib-group><aff id="I1"><label>1</label>Centre for Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, Australia</aff><aff id="I2"><label>2</label>Department of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Australia</aff><aff id="I3"><label>3</label>Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, East Melbourne, Australia</aff><aff id="I4"><label>4</label>The Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville, Australia</aff><aff id="I5"><label>5</label>Department of Nuclear Medicine, Centre Georges-François Leclerc, 1 rue Professeur Marion, Dijon Cedex 21079, France</aff><pub-date pub-type="collection"><year>2014</year></pub-date><pub-date pub-type="epub"><day>22</day><month>4</month><year>2014</year></pub-date><volume>14</volume><issue>1</issue><fpage>13</fpage><lpage>13</lpage><history><date date-type="received"><day>20</day><month>3</month><year>2014</year></date><date date-type="accepted"><day>20</day><month>3</month><year>2014</year></date></history><permissions><copyright-statement>Copyright © 2014 Cochet et al.; licensee BioMed Central Ltd.</copyright-statement><copyright-year>2014</copyright-year><copyright-holder>Cochet et al.; licensee BioMed Central Ltd.</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0">http://creativecommons.org/licenses/by/4.0</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><self-uri xlink:href="http://www.cancerimagingjournal.com/content/14/1/13"></self-uri><abstract><sec><title>Background</title><p>The incremental value of <sup>18</sup>FDG PET/CT in patients with breast cancer (BC) compared to conventional imaging (CI) in clinical practice is unclear. The aim of this study was to evaluate the management impact and prognostic value of <sup>18</sup> F-FDG PET/CT in this setting.</p></sec><sec><title>Methods</title><p>Sixty-three patients who were referred to our institution for suspicion of BC relapse were retrospectively enrolled. All patients had been evaluated with CI and underwent PET/CT. At a median follow-up of 61 months, serial clinical, imaging and pathologic results were obtained to validate diagnostic findings. Overall Survival (OS) was estimated using Kaplan Meier methods and analyzed using the Cox proportional hazards regression models.</p></sec><sec><title>Results</title><p>Forty-two patients had a confirmed relapse with 37 (88%) positive on CI and 40 (95%) positive on PET/CT. When compared with CI, PET/CT had a higher negative predictive value (86% versus 54%) and positive predictive value (95% versus 70%). The management impact of PET/CT was high (change of treatment modality or intent) in 30 patients (48%) and medium (change in radiation treatment volume or dose fractionation) in 6 patients (9%). Thirty-nine patients (62%) died during follow-up. The PET/CT result was a highly significant predictor of OS (Hazard Ratio [95% Confidence Interval] =4.7 [2.0-10.9] for PET positive versus PET negative for a systemic recurrence; p = 0.0003). In a Cox multivariate analysis including other prognosis factors, PET/CT findings predicted survival (p = 0.005). In contrast, restaging by CI was not significant predictor of survival.</p></sec><sec><title>Conclusion</title><p>Our study support the value of <sup>18</sup> F-FDG PET/CT in providing incremental information that influence patient management and refine prognostic stratification in the setting of suspected recurrent breast cancer.</p></sec></abstract><kwd-group><kwd>Breast cancer</kwd><kwd><sup>18</sup> F-FDG PET/CT</kwd><kwd>Restaging</kwd><kwd>Prognosis</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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