Document Detail


PET/CT with [18F] fluorodeoxyglucose in the assessment of metabolic response to neoadjuvant chemotherapy in locally advanced breast cancer.
MedLine Citation:
PMID:  22695339     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
AIM: The aim of this paper was to prospectively evaluate FDG PET/CT in the assessment of metabolic response to neoadjuvant chemotherapy and correlation with tumor cellularity in locally advanced breast cancer.
METHODS: Images were acquired with a PET/CT scanner in 50 patients at baseline and after completion of treatment, just before surgery. All findings were confirmed by histopathological analysis. PET/CT quantification (SUVmax) at baseline and after finishing neoadjuvant chemotherapy (4 cycles of epirubicin + cyclophosphamide +/- taxanes) were compared using RECIST criteria and Miller & Payne (M&P) scale.
RESULTS: Baseline mean tumor size was 4.4±1.6 cm. Thirty eight patients were considered responders and 12 nonresponders. According to M&P scale, 10 patients had good prognosis (grades 4-5) and 40 patients had bad prognosis (grades 1-3). All patients with grade 5 M&P had no significant postchemotherapy FDG uptake. Patients with bad prognosis had lower SUVmax variation (∆SUVmax) than patients with good prognosis (60.7% vs. 80.5%, P=0.0016). ∆SUVmax was lower in nonresponders than in partial responders according to RECIST criteria (38.9% vs. 67.6%, p<0.001), and was also lower in partial responders than complete responders (67.6% vs. 85.4%, P=0.005). A cut-off ∆SUVmax value of 52% differentiates responders from nonresponders with a sensitivity of 86% and a specificity of 90%. Probability densities of the ∆SUVmax (%) for stable disease (<45), partial (>45 to <82) and complete response (>82) showed an overall accuracy of 78% (Weighted Kappa=0.74).
CONCLUSION: PET/CT is useful to monitor response to neoadjuvant chemotherapy in locally advanced breast cancer. ∆SUVmax on PET/CT correlates with tumor cellularity after completion of neoadjuvant chemotherapy.
Authors:
J Duch; D Fuster; M Muñoz; P L Fernández; P Paredes; M Fontanillas; K Skaltsa; B Domènech; F Lomeña; F Pons
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The quarterly journal of nuclear medicine and molecular imaging : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of Radiopharmaceutical Chemistry and Biology     Volume:  56     ISSN:  1824-4785     ISO Abbreviation:  Q J Nucl Med Mol Imaging     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101213861     Medline TA:  Q J Nucl Med Mol Imaging     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  291-8     Citation Subset:  IM    
Affiliation:
Nuclear Medicine Department, Barcelona Clinical Provincial Hospital, Barcelona, Spain - joanduch@gmail.com.
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