18F-FDG PET/CT for early prediction of response to neoadjuvant chemotherapy in breast cancer

Purpose The aim of this study was to prospectively evaluate 18 F-FDG PET/CT in predicting response to neoadjuvant chemotherapy in large primary breast cancer. Methods Fifty consecutive patients underwent PET/CT at baseline and after the second cycle. Baseline MRI was performed to establish tumour si...

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Bibliographic Details
Published in:European journal of nuclear medicine and molecular imaging 2009-10, Vol.36 (10), p.1551-1557
Main Authors: Duch, Joan, Fuster, David, Muñoz, Montserrat, Fernández, Pedro Luís, Paredes, Pilar, Fontanillas, Montserrat, Guzmán, Flavia, Rubí, Sebastià, Lomeña, Francisco Juan, Pons, Francesca
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Breast cancer
Breast Neoplasms - diagnostic imaging
Breast Neoplasms - drug therapy
Cardiology
Chemotherapy
Female
Fluorine Radioisotopes
Fluorodeoxyglucose F18
Humans
Imaging
Medical imaging
Medical prognosis
Medicine
Medicine & Public Health
Middle Aged
Neoadjuvant Therapy
Nuclear Medicine
Oncology
Original Article
Orthopedics
Positron-Emission Tomography
Prospective Studies
Radiology
Radiopharmaceuticals
Tomography, X-Ray Computed
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Summary:Purpose The aim of this study was to prospectively evaluate 18 F-FDG PET/CT in predicting response to neoadjuvant chemotherapy in large primary breast cancer. Methods Fifty consecutive patients underwent PET/CT at baseline and after the second cycle. Baseline MRI was performed to establish tumour size. All findings were confirmed by histopathological analysis. Changes in maximum standardized uptake value (SUV max ) between baseline study and after two cycles of neoadjuvant chemotherapy (epirubicin + cyclophosphamide + taxanes) were compared using response evaluation criteria in solid tumours (RECIST) criteria and the Miller and Payne (M&P) scale. Results The mean tumour size was 4.3 ± 1.4 cm. Forty patients were considered responders and ten as non-responders. SUV max changes in patients with good prognosis (M&P grades 4–5) were higher than in patients with bad prognosis (M&P grades 1–3) ( p  = 0.025). SUV max changes between responders and non-responders following RECIST criteria were also statistically significant ( p  = 0.0028). A cut-off ΔSUV value of 40% differentiates both groups, with a sensitivity of 77% and a specificity of 80%. Conclusion 18 F-FDG PET/CT can predict response to neoadjuvant chemotherapy at an early stage.
ISSN:1619-7070
1619-7089
DOI:10.1007/s00259-009-1116-y