A new measure of response to therapy in bone-dominant breast cancer: A pilot study of serial quantitative F-(18)-Fluorodeoxyglucose Positron Emission Tomography

S. E. Stafford, J. R. Gralow, E. K. Schubert, L. K. Dunnwald, R. B. Livingston, K. J. Rinn, D. A. Mankoff

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Objectives: Standard evaluation of response to therapy in patients with bone metastases has utilized conventional imaging: bone scintigraphy, plain radiography, computed tomography and magnetic resonance imaging. Objective assessment of bone response remains problematic, however, in that changes lag response or my even worsen or "flare" before improving. Our study was undertaken to determine whether quantitative FDG PET could be used to monitor response of breast carcinoma bone metastases to therapy. Methods: Twenty-four women with stage IV bone- dominant breast carcinoma who were referred for serial FDG PET studies for staging over the course of therapy were included in this retrospective study. FDG scans were interpreted qualitatively and quantitatively using the maximum FDG standard uptake value (SUV) within the most conspicuous bony lesion on baseline FDG PET. PET results were compared to the change in tumor marker values (CA 27.29) and the overall assessment of response by a combination of conventional imaging, change in CA 27.29 and reported symptom changes to categorize response as PD (progression of disease), SD (stable disease) or R (regression of disease). We assessed the correlation between the change in FDG SUV versus the change in CA 27.29 and to the category of response using non-parametric rank correlation tests. Results: The change in FDG uptake with therapy strongly correlated with the change in tumor markers (p < 0.01) and also with overall clinical response (p < 0.01). In some patients, changes were seen by FDG PET in advance of similar changes seen later by bone scan or MRI. Conclusions: Serial whole-body FDG PET provides a quantitative assessment of breast cancer bone metastases response to therapy which correlates with tumor markers and standard clinical assessment of response. Prospective trials are warranted to determine the accuracy of serial FDG PET in measuring bony disease response in comparison to conventional imaging.

Original languageEnglish (US)
Number of pages1
JournalBreast Cancer Research and Treatment
Issue number3
StatePublished - Jan 1 2001


ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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