PET/CT bests contrast CT at monitoring metastatic breast cancers

PET/CT is superior to contrast-enhanced CT when it comes to predicting both progression-free and disease-specific survival in patients with metastatic breast cancer, according to a study published online May 1 in the European Journal of Nuclear Medicine and Molecular Imaging.

Christopher Riedl, MD, PhD, of Weill Cornell and colleagues followed 65 patients with metastatic breast cancer who were treated with first- or second-line systemic therapy in prospective clinical trials.

The team evaluated response to contrast CT and FDG PET/CT using, respectively, RECIST and PERCIST criteria.

They found that all responders by RECIST (n = 22) were also responders by PERCIST, but 40 percent (17 of 43) of non-responders by RECIST were responders by PERCIST.

Further, responses according to RECIST and PERCIST both correlated with progression-free survival, but PERCIST showed a significantly higher predictive accuracy (concordance index for progression-free survival: 0.70 vs. 0.60).

Also:

  • One-year progression-free survival for responders vs. non-responders by RECIST was 59 percent vs. 27 percent, compared to 63 percent vs. 0 percent by PERCIST.
  • Four-year disease-free survival of responders and non-responders by RECIST was 50 percent and 38 percent, respectively (p = 0.2, concordance index: 0.55) as compared to 58 percent vs. 18 percent for PERCIST (p < 0.001, concordance index: 0.65).

In addition, response on PET/CT proved “a significantly better predictor for disease-specific survival than disease control on contrast CT,” the authors report.

In patients with metastatic breast cancer, tumor response on PET/CT “appears to be a superior predictor of progression-free survival and disease-specific survival than response on CE-CT,” Riedl et al. conclude.

They add that monitoring tumor response by PET/CT “may increase the power of clinical trials using tumor response as an endpoint and may improve patient management in clinical routine.”

Dave Pearson

Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.

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