RT Journal Article SR Electronic T1 18F-FDG Uptake by Metastatic Axillary Lymph Nodes on Pretreatment PET/CT as a Prognostic Factor for Recurrence in Patients with Invasive Ductal Breast Cancer JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 1337 OP 1344 DO 10.2967/jnumed.111.098640 VO 53 IS 9 A1 Bong-Il Song A1 Sang-Woo Lee A1 Shin Young Jeong A1 Yee Soo Chae A1 Won Kee Lee A1 Byeong-Cheol Ahn A1 Jaetae Lee YR 2012 UL http://jnm.snmjournals.org/content/53/9/1337.abstract AB This study assessed the maximum standardized uptake value of metastatic axillary lymph nodes in patients with invasive ductal breast cancer (IDC) to determine the pretreatment prognostic value of 18F-FDG PET/CT for disease-free survival (DFS). Methods: Sixty-five female IDC patients who had undergone pretreatment 18F-FDG PET/CT and had pathologically confirmed axillary lymph node involvement without distant metastasis were enrolled. All patients showed complete remission after first-line treatment. To obtain nodal SUVmax, a transaxial image representing the highest 18F-FDG uptake was carefully selected and a region of interest was manually drawn on the 18F-FDG–accumulating lesion. Clinicopathologic parameters such as age, TNM stage, estrogen receptor status, progesterone receptor status, human epidermal growth factor receptor 2 status, and primary-tumor and nodal SUVmax on PET were analyzed for their usefulness in predicting recurrence. Combinatorial effects and interactions between variables that were significant by univariate analysis were examined using multivariate Cox proportional-hazards models. Results: Twelve of 65 patients (18.5%) experienced recurrence during follow-up (median follow-up, 36 mo; range, 21–57 mo). Nodal SUVmax was significantly higher in patients with recurrence than in those who were disease-free (recurrence group: 5.2 ± 2.3, vs. disease-free group: 1.9 ± 1.9, P < 0.0001). A receiver-operating-characteristic curve demonstrated a nodal SUVmax of 2.8 (sensitivity, 91.7%; specificity, 86.8%; area under the curve, 0.890) to be the optimal cutoff for predicting DFS. Univariate analysis revealed that T stage, N stage, estrogen receptor status, and primary-tumor and nodal SUVmax correlated significantly with DFS. Among these 5 variables, only nodal SUVmax was found to be a single determinant of DFS by multivariate analysis (hazard ratio, 31.54; 95% confidence interval, 2.66–373.39; P = 0.0065). Conclusion: Nodal SUVmax on pretreatment 18F-FDG PET/CT may be an independent prognostic factor for disease recurrence in patients with IDC.