18F-Fluoride PET/CT tumor burden quantification predicts survival in breast cancer.
PURPOSE
In bone-metastatic breast cancer patients, there are no current imaging biomarkers to identify which patients have worst prognosis. The purpose of our study was to investigate if skeletal tumor burden determined by 18F-Fluoride PET/CT correlates with clinical outcomes and may help define prognosis throughout the course of the disease.


RESULTS
Bone metastases were present in 49 patients. On multivariable analysis, skeletal tumor burden was significantly and independently associated with overall survival (p < 0.0001) and progression free-survival (p < 0.0001). The simple presence of bone metastases was associated with time to bone event (p = 0.0448).


MATERIALS AND METHODS
We quantified the skeletal tumor burden on 18F-Fluoride PET/CT images of 107 female breast cancer patients (40 for primary staging and the remainder for restaging after therapy). Clinical parameters, primary tumor characteristics and skeletal tumor burden were correlated to overall survival, progression free-survival and time to bone event. The median follow-up time was 19.5 months.


CONCLUSIONS
18F-Fluoride PET/CT skeletal tumor burden is a strong independent prognostic imaging biomarker in breast cancer patients.
['Brito|Ana E|AE|', 'Santos|Allan|A|', 'Sasse|André Deeke|AD|', 'Cabello|Cesar|C|', 'Oliveira|Paulo|P|', 'Mosci|Camila|C|', 'Souza|Tiago|T|', 'Amorim|Barbara|B|', 'Lima|Mariana|M|', 'Ramos|Celso D|CD|', 'Etchebehere|Elba|E|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D001859:Bone Neoplasms D001842:Bone and Bones D001940:Breast D001943:Breast Neoplasms D005260:Female D019788:Fluorodeoxyglucose F18 D005500:Follow-Up Studies D006801:Humans D008875:Middle Aged D064847:Multimodal Imaging D000072078:Positron Emission Tomography Computed Tomography D011379:Prognosis D016019:Survival Analysis D047368:Tumor Burden
breast cancer skeletal tumor burden bone metastases NaF PET/CT fluoride-PET/CT