PT  - JOURNAL ARTICLE
AU  - Brett Marinelli
AU  - Carina Espinet
AU  - Gary Ulaner
AU  - Maxine Jochelson
AU  - Wolfgang Weber
TI  - Predicting survival in metastatic triple negative breast cancer patients with FDG PET/CT-based tumor volume quantification
DP  - 2014 May 01
TA  - Journal of Nuclear Medicine
PG  - 622--622
VI  - 55
IP  - supplement 1
4099  - http://jnm.snmjournals.org/content/55/supplement_1/622.short
4100  - http://jnm.snmjournals.org/content/55/supplement_1/622.full
SO  - J Nucl Med2014 May 01; 55
AB  - 622 Objectives Patients with metastatic triple negative breast cancer (MTNBC) can present with a wide range of disease burden. We investigated if tumor burden quantified by PET/CT may identify prognostic subgroups in MTNBC patients. Methods PET/CT scans in 61 MTNBC patients (age 55+/-13) between 2001-2012 were evaluated retrospectively. FDG avid lesions suspicious for malignancy were identified, tissue type estimated (primary, lymph node, bone, lung, or liver), and SUVmax, total lesion glycolysis (TLG), total lesion number (TLN) and total tumor volume (TTV) measured. Tumor volumes were made with a 42% isocontour of the maximum SUV with GE AW software. Adjustments of the 42% threshold was made if the volume extended beyond the lesion on CT. These parameters were compared for their prognostic value by Mantel-Cox tests and Cox regression analysis. Results A total of 413 lesions with a SUVmax (2.7 - 46.3, median 11.9) were analyzed. TTV ranged from 3.0 - 450 with a median of 58 ml. Correction of TTV were made in 12 lesions. At a median follow-up time of 12.4 months, 49 patients died with a median overall survival of 12.1 months. Patients with TTV less than the median lived twice as long (22 vs 11 months) as those with a TTV higher than the median (χ2 =32.3, P<0.0001). Cox regression of SUVmax, TLG, TLN, age and presence of visceral lesions were non-significant except TTV with a hazard ratio of 4.75 and p<0.001. Conclusions In patients with MTNBC, TTV is straightforward to determine by routine software and appears to be a strong independent prognostic factor. If confirmed in prospective studies, TTV may be a tool for risk stratification of MTNBC patients in clinical trials, but may also aid treatment decisions in MTNBC patients.