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

Joan Duch*, David Fuster, Montserrat Munoz, Pedro Luis Fernandez, Pilar Paredes, Montserrat Fontanillas, Flavia Guzman, Sebastia Rubi, Francisco Juan Lomena, Francesca Pons

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

114 Citations (Scopus)

Abstract

Purpose The aim of this study was to prospectively evaluate F-18-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 (SUVmax) 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. SUVmax 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). SUVmax changes between responders and non-responders following RECIST criteria were also statistically significant (p= 0.0028). A cut-off Delta SUV value of 40% differentiates both groups, with a sensitivity of 77% and a specificity of 80%.

Conclusion F-18-FDG PET/CT can predict response to neoadjuvant chemotherapy at an early stage.

Original languageEnglish
Pages (from-to)1551-1557
Number of pages7
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume36
Issue number10
DOIs
Publication statusPublished - Oct 2009

Keywords

  • Breast cancer
  • PET/CT
  • Early prediction response
  • Neoadjuvant chemotherapy
  • POSITRON-EMISSION-TOMOGRAPHY
  • CELL LUNG-CANCER
  • PATHOLOGICAL RESPONSE
  • FDG-PET
  • PREOPERATIVE CHEMOTHERAPY
  • INDUCTION CHEMOTHERAPY
  • TUMOR RESPONSE
  • CARCINOMA
  • FLUORODEOXYGLUCOSE
  • THERAPY

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