Prognostic Value of Percentage Change in Metabolic Parameters as Measured by Dual-Time Point ¹⁸F-FDG PET/CT in Premenopausal Women with Invasive Ductal Breast Carcinoma

Objectives: We retrospectively evaluated the prognostic significance of dual-time point (DTP) ¹⁸F-FDG positron emission tomography/computed tomography (PET/CT) parameters compared with clinicopathological findings in premenopausal women with invasive ductal breast carcinoma (IDC). Materials and Methods: Sixty-six premenopausal women (mean age: 42.7 ± 5.6, range: 29.5-51.8 years) who had pathologically confirmed IDC were enrolled. The maximum standardized uptake value (SUV_max), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured and used to calculate percentage changes over the DTP time interval. We analyzed the prognostic significance of DTP PET/CT parameters, clinicopathological factors of pathologic tumor diameter (pTD), axillary lymph node status (ANS), nuclear grade, histologic grade, and immunohistochemistry findings using univariate and multivariate analyses. Results: Disease recurrence was observed in 22 patients. In univariate analysis, SUV_max > 7.39, MTV > 4.28, TLG > 52.38, %ΔSUV_max > 20.44, %ΔTLG >-13.86, pTD > 2.8 cm, positive ANS, estrogen receptor (ER) negativity, and triple negativity were associated with worse prognosis than those of opposite groups in recurrence-free survival (all p < 0.05). %ΔSUV_max (>20.44, p = 0.0042), TLG (>52.38, p = 0.0002), and ER negativity (p = 0.0003) were independent prognostic variables after multivariate analysis. Conclusion: Percentage changes in SUV_max using DTP PET/CT and TLG were significant independent prognostic factors of disease recurrence along with ER negativity in premenopausal women with IDC.