PET/CT Predicts Survival in Breast Cancer Patients with Hepatic Metastases

FDG PET/CT before and after selective internal radiation therapy (SIRT) can help predict survival among patients with breast cancer with hepatic metastases, researchers found.

A study published in the March issue of the Journal of Nuclear Medicine involved 58 women with breast cancer who underwent SIRT a mean of 467 weeks +/- 365 weeks following initial diagnosis. The patients underwent both a whole-body FDG PET/CT 3D scan and contrast-enhanced MRI of the liver before beginning treatment. These were repeated three months following treatment in 43 of the patients.

The researchers measured the maximum standardized uptake value (SUVMAX) of the hepatic metastases and compared the findings from the second exam to the first. They used up to five of the most notable hepatic metastases.

Researchers found that patients who responded favorably to the treatment, having a greater chance of survival, had a decrease of greater than 30 percent from baseline; those who had new metastases or a decrease of less than 30 percent meant poor or no response, and did not predict survival. “Furthermore, a high pretherapeutic SUVMAX (higher than 20) was associated with a significantly shorter median survival than was an SUVMAX of equal to or lower than 20,” wrote the authors.

Overall median survival after SIRT was 47 weeks, 65 weeks for favorable responders and 43 weeks for non-responders. Of the 43 patients who were tested after treatment, 11 (26 percent) had partial response to treatment, 27 (63 percent) had stable disease, and five (11 percent) had progressive disease.