FDG PET/CT, Precise Positioning of the Criminal Focus in the Osteogenic Region of Breast Cancer Bone Metastases after Therapy

Abstract

Abstract Purpose The present study endeavours to investigate the utility and indispensability of FDG PET/CT in appraising the post-treatment efficacy of bone metastasis in cases of breast cancer. Method A cohort of 11 patients diagnosed with breast cancer and suffering from bone metastases was enrolled for this investigation. These patients underwent repeated FDG PET/CT evaluations, with comprehensive clinical records and sufficient follow-up duration available. Division of patients and bone metastases ensued into three distinct groups - amelioration, stability, and progression - predicated upon the response exhibited by each bone metastatic site subsequent to treatment. The ensuing analysis and juxtaposition encompassed PET and CT image alterations, levels of serum tumour biomarkers (CEA, CA153), as well as biochemical indicators (ALP, Ca), within each group across the identical time frame. Furthermore, the inquiry scrutinized disparities between immunohistochemical outcomes of primary breast cancer and bone metastases displaying escalated FDG uptake as discerned through PET/CT post-treatment. Results Discernible disparities in serological indices (CEA, CA153, ALP, and Ca) were absent among patients classified under distinct efficacy categories (p > 0.05). Nonetheless, diminished expression of Her-2 engendered an elevated likelihood of suboptimal efficacy (p < 0.05). Appraisal of efficacy, guided by individual bone metastases, unveiled notable fluctuations in FDG uptake through PET (SUVmax) amid the three groups (p < 0.05), while density variations in CT scans did not reach statistical significance (p = 0.243). Variances surfaced in FDG uptake, alterations in CT density, and levels of CEA and CA153 within patient sera before and after treatment (p < 0.05). Of these indicators, paramount diagnostic efficacy was ascribed to FDG PET metrics: alterations in FDG uptake (AUC 0.972) and post-therapy SUVmax (AUC 0.949). Immunohistochemical examination of bone metastases within the progressive group diverged from primary lesions. Conclusions FDG PET/CT confers precise assessment of the post-treatment efficacy pertaining to each bone metastatic site in breast cancer cases. The modality facilitates identification of eluding foci following extant therapies, localization for pathological assessment, and bears substantive significance in evaluating therapeutic efficacy, refining treatment stratagems, and prognosticating the trajectory for breast cancer patients contending with bone metastases.