Elevated Splenic 18F-fluorodeoxyglucose Positron Emission Tomography/computed Tomography Activity is Associated with 5-year Risk of Recurrence in Non-metastatic Invasive Ductal Carcinoma of the Breast

Overview

Journal Br J Radiol

Publisher Oxford University Press

Specialty Radiology

Date 2024 Jan 24

PMID 38263821

Authors

Yiting Wang

Yuchao Li

Hongyuan Jiang

Changjing Zuo

Wengui Xu

Affiliations

Soon will be listed here.

Abstract

Objective: To construct prediction models including baseline 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) metabolic parameters of tumoural lesions and non-tumour lymphoid tissue for recurrence-free survival within 5 years (5y-RFS) after imaging examination in patients with invasive ductal carcinomas (IDCs) of the breast.

Methods: The study included 101 consecutive female patients. Univariable and multivariable Cox regression were used to identify clinicopathological and metabolic parameters associated with risk of recurrence. Four prediction models based on the results of multivariable analysis were constructed and visualized as nomograms. Performance of each nomogram was evaluated using the concordance index (C-index), integrated discrimination improvement, decision curve analysis (DCA), and calibration curve.

Results: N3 status, total metabolic tumour volume, the maximum standardized uptake value of spleen, and spleen-to-liver ratio were significant predictors of 5y-RFS. The nomogram including all significant predictors demonstrated superior predictive performance for 5y-RFS, with a C-index of 0.907 (95% CI, 0.833-0.981), greatest net benefit on DCA, good accuracy on calibration curves, and excellent risk stratification on Kaplan-Meier curves.

Conclusions: The model that included metabolic parameters of the spleen had the best performance for predicting 5y-RFS in patients with IDCs of the breast. This model may guide personalized treatment decisions and inform patients and clinicians about prognosis.

Advances In Knowledge: This research identifies 18F-FDG PET/CT metabolic parameters of non-tumour lymphoid tissue as predictors of recurrence in breast cancer.

Citing Articles

Evaluating the correlation between pretreatment F-FDG PET/CT metabolic parameters and tumor-infiltrating lymphocyte levels in nonluminal breast cancer and impact on survival.

Tamam M, Ozcevik H, Kulduk G, Acar Tayyar M, Babacan G Pathol Oncol Res. 2025; 30():1612014.

PMID: 39839836 PMC: 11750436. DOI: 10.3389/pore.2024.1612014.

Development and validation of a nomogram for incorporating F-FDG PET/CT spleen uptake for predicting prognosis in elderly esophageal cancer patients treated with radiotherapy.

Liu D, Lin D, Lin Z, Peng Y, Cai S, Yang Q J Thorac Dis. 2024; 16(11):7853-7865.

PMID: 39678872 PMC: 11635226. DOI: 10.21037/jtd-24-1698.

References

Groheux D, Majdoub M, Tixier F, Rest C, Martineau A, Merlet P . Do clinical, histological or immunohistochemical primary tumour characteristics translate into different (18)F-FDG PET/CT volumetric and heterogeneity features in stage II/III breast cancer?. Eur J Nucl Med Mol Imaging. 2015; 42(11):1682-1691. PMC: 5395661. DOI: 10.1007/s00259-015-3110-x. View

Qu X, Tang Y, Hua S . Immunological Approaches Towards Cancer and Inflammation: A Cross Talk. Front Immunol. 2018; 9:563. PMC: 5890100. DOI: 10.3389/fimmu.2018.00563. View

Bural G, Torigian D, Chen W, Houseni M, Basu S, Alavi A . Increased 18F-FDG uptake within the reticuloendothelial system in patients with active lung cancer on PET imaging may indicate activation of the systemic immune response. Hell J Nucl Med. 2010; 13(1):23-5. View

Bouron C, Mathie C, Seegers V, Morel O, Jezequel P, Lasla H . Prognostic Value of Metabolic, Volumetric and Textural Parameters of Baseline [F]FDG PET/CT in Early Triple-Negative Breast Cancer. Cancers (Basel). 2022; 14(3). PMC: 8833829. DOI: 10.3390/cancers14030637. View

Xiao Y, Yu D . Tumor microenvironment as a therapeutic target in cancer. Pharmacol Ther. 2020; 221:107753. PMC: 8084948. DOI: 10.1016/j.pharmthera.2020.107753. View

Nilupai A, Wang J, Zhang P, Ma F, Yuan P, Luo Y . [Analysis of the effect of ipsilateral supraclavicular lymph node metastasis on the prognosis of N3 breast cancer]. Zhonghua Zhong Liu Za Zhi. 2021; 43(10):1069-1075. DOI: 10.3760/cma.j.cn112152-20191227-00845. View

Im H, Bradshaw T, Solaiyappan M, Cho S . Current Methods to Define Metabolic Tumor Volume in Positron Emission Tomography: Which One is Better?. Nucl Med Mol Imaging. 2018; 52(1):5-15. PMC: 5777960. DOI: 10.1007/s13139-017-0493-6. View

Amin M, Greene F, Edge S, Compton C, Gershenwald J, Brookland R . The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging. CA Cancer J Clin. 2017; 67(2):93-99. DOI: 10.3322/caac.21388. View

Lee J, Choi J, Lyu J, Lee S . Prognostic significance of F-fluorodeoxyglucose uptake of bone marrow measured on positron emission tomography in patients with small cell lung cancer. Lung Cancer. 2018; 118:41-47. DOI: 10.1016/j.lungcan.2018.01.020. View

10.

Dias A, Almeida C, Helguero L, Duarte I . Metabolic crosstalk in the breast cancer microenvironment. Eur J Cancer. 2019; 121:154-171. DOI: 10.1016/j.ejca.2019.09.002. View

11.

Lee J, Kim S, Han S, Lee J, Lee H, Heo N . [F]FDG uptake of bone marrow on PET/CT for predicting distant recurrence in breast cancer patients after surgical resection. EJNMMI Res. 2020; 10(1):72. PMC: 7326752. DOI: 10.1186/s13550-020-00660-y. View

12.

Ahn S, Hwang S, Jung S, Lee S, Park Y, Yun M . Evaluation of Spleen Glucose Metabolism Using F-FDG PET/CT in Patients with Febrile Autoimmune Disease. J Nucl Med. 2016; 58(3):507-513. DOI: 10.2967/jnumed.116.180729. View

13.

Hashemi V, Maleki L, Esmaily M, Masjedi A, Ghalamfarsa G, Namdar A . Regulatory T cells in breast cancer as a potent anti-cancer therapeutic target. Int Immunopharmacol. 2019; 78:106087. DOI: 10.1016/j.intimp.2019.106087. View

14.

Alshetaiwi H, Pervolarakis N, McIntyre L, Ma D, Nguyen Q, Rath J . Defining the emergence of myeloid-derived suppressor cells in breast cancer using single-cell transcriptomics. Sci Immunol. 2020; 5(44). PMC: 7219211. DOI: 10.1126/sciimmunol.aay6017. View

15.

Lee J, Lee S, Kim H, Lee S . Prognostic value of bone marrow F-FDG uptake on PET/CT in lymphoma patients with negative bone marrow involvement. Hell J Nucl Med. 2017; 20(1):17-25. DOI: 10.1967/s002449910502. View

16.

Seban R, Nemer J, Marabelle A, Yeh R, Deutsch E, Ammari S . Prognostic and theranostic 18F-FDG PET biomarkers for anti-PD1 immunotherapy in metastatic melanoma: association with outcome and transcriptomics. Eur J Nucl Med Mol Imaging. 2019; 46(11):2298-2310. DOI: 10.1007/s00259-019-04411-7. View

17.

Seban R, Robert C, Dercle L, Yeh R, Dunant A, Reuze S . Increased bone marrow SUVmax on 18F-FDG PET is associated with higher pelvic treatment failure in patients with cervical cancer treated by chemoradiotherapy and brachytherapy. Oncoimmunology. 2019; 8(5):e1574197. PMC: 6492982. DOI: 10.1080/2162402X.2019.1574197. View

18.

Reinert T, Souza A, Sartori G, Obst F, Barrios C . Highlights of the 17th St Gallen International Breast Cancer Conference 2021: customising local and systemic therapies. Ecancermedicalscience. 2021; 15:1236. PMC: 8225331. DOI: 10.3332/ecancer.2021.1236. View

19.

Lee J, Na J, Kang D, Lee S, Lee S . Prognostic Significance of FDG Uptake of Bone Marrow on PET/CT in Patients With Non-Small-Cell Lung Cancer After Curative Surgical Resection. Clin Lung Cancer. 2016; 18(2):198-206. DOI: 10.1016/j.cllc.2016.07.001. View

20.

Wong A, Callahan J, Keyaerts M, Neyns B, Mangana J, Aberle S . F-FDG PET/CT based spleen to liver ratio associates with clinical outcome to ipilimumab in patients with metastatic melanoma. Cancer Imaging. 2020; 20(1):36. PMC: 7227105. DOI: 10.1186/s40644-020-00313-2. View