Dongsan Medical Center, Keimyung University School of Medicine, Korea
Posters & Accepted Abstracts: Oncol Cancer Case Rep
Objectives: This study assessed whether volume-based parameters of primary-tumor measured by preoperative F-18 FDG PET/CT could have the predictive value for Axillary Lymph Node (ALN) metastasis prediction in invasive ductal breast cancer (IDC). Methods: A total of 57 female patients (mean age, 49.4 Ã?Â± 9.5) with IDC who underwent surgical resection of primary tumor with sentinel lymph node biopsy and/or axillary LN dissection without any neoadjuvant treatment were analyzed. Metabolically active tumor regions were delineated on pretreatment PET scans semi-automatically using custom software. Maximum standardized uptake value (SUVmax) and metabolic tumor volume (MTV) were used. To obtain the MTV, we used a threshold of SUV 2.0, 25%, 50% and 75% for the SUVmax. Results: LN metastasis was found in 20 patients (35.1%). MTV-75% and MTV-50% were significantly higher in patient with LN metastasis (P = 0.005 and 0.015). However, SUVmax, MTV-2.0, and MTV-25% showed no significant difference. On receiver operating characteristic (ROC) curve analysis, MTV-75% (area under the curve (AUC) = 0.726, 95% confidence interval [95% confidence interval (CI)] 0.591Ã¢Â?Â?0.839) and MTV-50% (AUC = 0.696, 95% CI 0.560Ã¢Â?Â?0.811) showed good predictive performance for LN metastasis. Conclusion: MTV-75% and MTV-50% as determined by F-18 PET/CT demonstrated a statistically significant correlation with LN metastasis in patients with IDC. Therefore, patients with high values of MTV on pretreatment F-18 FDG PET/CT should be cautiously evaluated for LN metastasis.