FDG PET evaluation of early axillary lymph node response to neoadjuvant chemotherapy in stage II and III breast cancer patients

Purpose Regional axillary lymph node status has remained the single most independent variable to predict prognosis both in terms of disease recurrence and survival. This study aimed to prospectively assess sequential [ 18 F]fluorodeoxyglucose (FDG) positron emission tomography (PET) findings as earl...

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Bibliographic Details
Published in:European journal of nuclear medicine and molecular imaging 2011-06, Vol.38 (6), p.1029-1036
Main Authors: Rousseau, Caroline, Devillers, Anne, Campone, Mario, Campion, Loïc, Ferrer, Ludovic, Sagan, Christine, Ricaud, Myriam, Bridji, Boumédiène, Kraeber-Bodéré, Françoise
Format: Article
Language:English
Subjects:
Adult
Aged
Biological Transport
Breast cancer
Breast Neoplasms - diagnostic imaging
Breast Neoplasms - metabolism
Breast Neoplasms - pathology
Breast Neoplasms - therapy
Cardiology
Chemotherapy
Fluorodeoxyglucose F18 - metabolism
Humans
Imaging
Lymph Nodes - diagnostic imaging
Lymph Nodes - pathology
Lymphatic Metastasis
Lymphatic system
Medical prognosis
Medicine
Medicine & Public Health
Middle Aged
Neoadjuvant Therapy
Neoplasm Staging
Nuclear Medicine
Oncology
Original Article
Orthopedics
Positron-Emission Tomography
Radiology
Tomography
Treatment Outcome
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Summary:Purpose Regional axillary lymph node status has remained the single most independent variable to predict prognosis both in terms of disease recurrence and survival. This study aimed to prospectively assess sequential [ 18 F]fluorodeoxyglucose (FDG) positron emission tomography (PET) findings as early predictors of axillary lymph node response to neoadjuvant chemotherapy in stage II and III breast cancer patients. Methods Images were acquired with a PET/CT scanner in 52 patients after administration of FDG (5 MBq/kg) at baseline and after the first, second, third and sixth course of chemotherapy before surgery. Clinical examination and ultrasound (US) were used to assess the size of axillary nodes. Decrease in the standardized uptake value (SUV) with PET corrected or not for partial volume effects was compared to the pathological response. Results The sensitivity, specificity and accuracy of axillary node staging was higher with PET (75, 87 and 80%) than with US (50, 83 and 65%), and even more so when PET images were corrected for partial volume effects (86, 83 and 84%). While FDG uptake did not vary much in non-responders, as confirmed by histopathological analysis, it markedly decreased to baseline levels in responders ( p  
ISSN:1619-7070
1619-7089
DOI:10.1007/s00259-011-1735-y