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. 2023 Jan 4:12:976823.
doi: 10.3389/fonc.2022.976823. eCollection 2022.

The predictive and prognostic role of metabolic and volume-based parameters of positron emission tomography/computed tomography as non-invasive dynamic biological markers in early breast cancer treated with preoperative systemic therapy

Alessandro Inno  1 , Marta Peri  1   2 , Monica Turazza  1 , Giuseppe Bogina  3 , Alessandra Modena  1 , Alberto Massocco  4 , Modestino Pezzella  4 , Matteo Valerio  1 , Rosario Mazzola  5 , Laura Olivari  6 , Fabrizia Severi  7 , Giovanni Foti  8 , Cristina Mazzi  9 , Fabiana Marchetti  9 , Gianluigi Lunardi  10 , Matteo Salgarello  6 , Antonio Russo  2 , Stefania Gori  1
Affiliations

The predictive and prognostic role of metabolic and volume-based parameters of positron emission tomography/computed tomography as non-invasive dynamic biological markers in early breast cancer treated with preoperative systemic therapy

Alessandro Inno et al. Front Oncol. .

Abstract

Introduction: The role of fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in early breast cancer treated with preoperative systemic therapy (PST) is not yet established in clinical practice. PET parameters have aroused great interest in the recent years, as non-invasive dynamic biological markers for predicting response to PST.

Methods: In this retrospective study, we included 141 patients with stage II-III breast cancer who underwent surgery after PST. Using ROC analysis, we set optimal cutoff of FDG-PET/CT parameters predictive for pathological complete response (pCR). We investigated the correlation between FDG-PET/CT parameters and pCR, median disease-free survival (DFS), and median overall survival (mOS).

Results: At multivariable analysis, baseline SUVmax (high vs low: OR 9.00, CI 1.85 - 61.9, p=0.012) and Delta SUVmax (high vs low: OR 9.64, CI 1.84, 69.2, p=0.012) were significantly associated with pCR rates. Interestingly, we found that a combined analysis of the metabolic parameter Delta SUVmax with the volume-based parameter Delta MTV, may help to identify patients with pCR, especially in the subgroup of hormone receptor positive breast cancer. Delta SUVmax was also an independent predictive marker for both mDFS (high vs low: HR 0.17, 95%CI 0.05-0.58, p=0.004) and mOS (high vs. low: HR 0.19, 95%CI 0.04-0.95, p=0.029).

Discussion: Our results suggest that Delta SUVmax may predict survival of early BC patients treated with PST.

Keywords: PET CT scan; SUV; early breast cancer; predictive factors; preoperative chemotherapy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Disease-free survival (A) and overall survival (B) according to pCR.
Figure 2
Figure 2
Disease-free survival (A) and overall survival (B) according to Delta SUVmax.
Figure 3
Figure 3
Disease-free survival (A) and overall survival (B) according to Delta MTV.
Figure 4
Figure 4
Disease-free survival (A) and overall survival (B) according to Delta TLG.
See this image and copyright information in PMC

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