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European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-08-2015 | Original Article

^99mTc-3PRGD₂ SPECT to monitor early response to neoadjuvant chemotherapy in stage II and III breast cancer

Authors: Bin Ji, Bin Chen, Ting Wang, Yan Song, Minglong Chen, Tiefeng Ji, Xueju Wang, Shi Gao, Qingjie Ma

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 9/2015

Abstract

Purpose

Monitoring of response to neoadjuvant chemotherapy (NCT) is important for optimal management of patients with breast cancer. ^99mTc-3PRGD₂ SPECT is a newly developed imaging modality for evaluating tumor vascular status. In this study, we investigated the application of ^99mTc-3PRGD₂ SPECT in evaluating therapy response to NCT in patients with stage II or III breast cancer.

Methods

Thirty-three patients were scheduled to undergo ^99mTc-3PRGD₂ SPECT at baseline, after the first and second cycle of NCT. Four patients had extremely low ^99mTc-3PRGD₂ uptake at baseline, and were not included in the subsequent studies. Changes in tumor to nontumor (T/N) ratio were compared with pathological tumor responses classified using the residual cancer burden system. Receiver operator characteristic analysis was used to compare the power to identify responders between the end of the first and the end of the second cycle of NCT. The impact of breast cancer subtype on ^99mTc-3PRGD₂ uptake was evaluated. The correlation between ^99mTc-3PRGD₂ uptake and pathological tumor response was also evaluated in each breast cancer subtype.

Results

Surgery was performed after four cycles of NCT and pathological analysis revealed 18 responders and 15 nonresponders. In patients with clearly visible ^99mTc-3PRGD₂ uptake at baseline, the sensitivity, specificity, and negative predictive value of ^99mTc-3PRGD₂ SPECT were 86.7 %, 85.7 % and 86.7 % after the first cycle of NCT, and 92.9 %, 93.3 % and 93.3 % after the second cycle, respectively. Among these patients, the HER-2-positive group demonstrated both higher T/N ratios and a greater change in T/N ratio than patients with other breast cancer subtypes (P < 0.05). A strong correlation was found between changes in T/N ratio and pathological tumor response in the HER-2-positive group (P < 0.03).

Conclusion

^99mTc-3PRGD₂ SPECT seems to be useful for determining the pathological tumor response in patients with stage II or III breast cancer undergoing NCT, especially those with the HER-2-positive subtype.

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Title: 99mTc-3PRGD2 SPECT to monitor early response to neoadjuvant chemotherapy in stage II and III breast cancer
Authors: Bin Ji
Bin Chen
Ting Wang
Yan Song
Minglong Chen
Tiefeng Ji
Xueju Wang
Shi Gao
Qingjie Ma
Publication date: 01-08-2015
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 9/2015
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-015-3062-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

^99mTc-3PRGD₂ SPECT to monitor early response to neoadjuvant chemotherapy in stage II and III breast cancer

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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