Heterogeneity has been demonstrated to be a predictor of treatment failure and drug resistance. Our study aimed to investigate imaging parameters, including tumor heterogeneity, as prognostic factors of response to 500 mg fulvestrant using 18F-FDG PET/CT. Twenty-seven estrogen receptor (HR)-positive/HER2-negative metastatic breast cancer patients who received 500 mg fulvestrant and underwent 18F-FDG PET/CT before treatment were retrospectively included. In PET/CT scans, conventional parameters (maximum and mean standardized uptake value, metabolic tumor volume [MTV], total lesion glycolysis [TLG]) and heterogeneity parameters (intra-tumor heterogeneity index [HI] and inter-tumor heterogeneity coefficient of variation [COV]) were analyzed. Progression-free survival (PFS) was mainly assessed for efficacy. The survival analyses were performed using the Kaplan-Meier method. Univariate and multivariate analysis were performed using the Cox proportional hazard model. Univariate analysis indicated that a high SUVmax and a high tumor HI at baseline were associated with longer PFS of fulvestrant (P = 0.036 and P =0.033, respectively). Liver metastasis, SUVmax and HI were statistically significant in multivariate analysis (P values of 0.017, 0.025 and 0.043, respectively). 18F-FDG based intra-tumor heterogeneity appears to be a potential predicator of efficacy of fulvestrant among HR+HER2- metastatic breast cancer patients.
[1]Fudan Univ, Shanghai Med Coll, Dept Oncol, Dept Med Oncol,Shanghai Canc Ctr, Shanghai 200032, Peoples R China;
[2]Fudan Univ, Shanghai Engn Res Ctr Mol Imaging Probes, Dept Oncol,Shanghai Med Coll, Dept Nucl Med,Shanghai Canc Ctr,Ctr Biomed Imagin, Shanghai 200032, Peoples R China;
[3]Fudan Univ, MOE, Key Lab Nucl Phys & Ion Beam Applicat, Shanghai 200433, Peoples R China;
[4]Fudan Univ, Shanghai Med Coll, Dept Biochem & Mol Biol, Key Lab Glycoconjugate Res,Minist Publ Hlth, Shanghai, Peoples R China
(8.0+极速模式)