Clinical Relevance of the Standardized Uptake Value (Suv) in Staging Breast Cancer with FDG-PET/CT

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Purpose : FDG-PET/CT with standardized uptake value (SUV) estimation was applied to breast cancer patients for the purpose of preoperative evaluation of the extent of the disease. Methods : FDG-PET/CT was performed preoperatively in 71 patients with breast cancer, and the maximum standardized uptake value (SUVmax) of tumors, as well as combination of SUVmax and tumor marker CA 15-3 were investigated for a significant association with lymph node spread and distant metastasis. Results : Tumor SUVmax high (>3.1) was found to have a reliable predictive value for lymph node spread (sensitivity 82.9%, specificity 75%, P<0.0001), while SUVmax-High (>3.8)/CA 15-3-Elevated was found to be superior for the prediction of metastasis (sensitivity ; 75%, specificity ; 92.7%, P=0.0001). Moreover, linear regression analysis identified the best correlation was between SUVmax-High (>3.1) with lymph node spread {correlation coefficient (r^2)=0.580, P=0.0001}, and SUVmax-High (>3.8)/CA 15-3-Elevated with distant metastasis {correlation coefficient (r^2)=0.677, P<0.0001}. Conclusions : SUVmax is a reliable predictor of lymph node spread, and if combined with tumor marker assay (CA 15-3) labeled SUVmax-High/CA 15-3-Elevated is sufficient for the early detection of breast cancer metastasis. This outcome suggests that the FDG-PET/CT findings with SUV calculation could have a strong positive impact on breast cancer patients.
獨協医科大学の論文