Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 6/2009

01-06-2009 | Breast

The role of 18F-FDG PET/CT in evaluation of early response to neoadjuvant chemotherapy in patients with locally advanced breast cancer

Authors: Amandeep Kumar, Rakesh Kumar, Vathalaru Seenu, Sidharatha Datta Gupta, Madhavi Chawla, Arun Malhotra, Sada Nand Mehta

Published in: European Radiology | Issue 6/2009

Login to get access

Abstract

We evaluated the role of 18F-FDG PET/CT for the assessment of response after two cycles of neo-adjuvant chemotherapy (NACT) for breast cancer. Twenty-three women with locally advanced breast cancer were included in this study. Early response to NACT was evaluated after two cycles using clinical examination, CT, and 18F-FDG PET/CT. Final histopathology following surgery after six cycles of NACT served as reference. Baseline PET/CT demonstrated a total of 26 lesions in 23 patients. The size of the primary tumor ranged from 1.90 cm to 11.60 cm, and the maximum value of the standardized uptake value of FDG (SUVmax) ranged from 3.6 to 38.6 (mean, 11.7). Post-chemotherapy PET/CT examinations were done after two cycles of NACT. The size of the primary tumor on follow-up PET/CT examinations ranged from 0.0 cm to 7.6 cm, and SUVmax ranged from 0.0 to 12.0 (mean, 3.96). On clinical, CT, and PET/CT examinations, 50% reduction in the parameters was taken as the cutoff value to differentiate between responders and non-responders. Post-NACT PET/CT demonstrated that 16 patients were responders and 7 non-responders. Among 16 responders on PET/CT scan, 14 were true positive and 2 were false positive when compared with histopathology. Among seven non-responder patients, six were true negative, and one was false negative. The sensitivity, specificity, and accuracy of PET/CT in detecting responders were 93%, 75%, and 87%, respectively. In conclusion, 18F-FDG PET/CT can differentiate responders from non-responders with high accuracy after two cycles of NACT in patients with LABC.
Literature
1.
Jemal A, Clegg LX, Ward E et al (2004) Annual report to the nation on the status of cancer, 1975–2001, with a special feature regarding survival. Cancer 101:3–27PubMedCrossRef
2.
Ferlay J, Autier P, Boniol M et al (2007) Estimates of the cancer incidence and mortality in Europe in 2006. Ann Oncol 18(3):581–592PubMedCrossRef
3.
Haagensen CD, Stout AP (1942) Carcinoma of the breast: I. Results of treatment. Ann Surg 116:801–815PubMedCrossRef
4.
Haagensen CD, Stout AP (1943) Carcinoma of the Breast: II. Criteria of operability. Ann Surg 118:859–870 1032–51PubMedCrossRef
5.
Bonadonna G, Valagussa P, Zucali R et al (1995) Primary chemotherapy in surgically resectable breast cancer. CA Cancer J Clin 45:227–243PubMedCrossRef
6.
Wang H, Lo S (1996) Future prospects of neoadjuvant chemotherapy in treatment of primary breast cancer. Semin Surg Oncol 12:59–66PubMedCrossRef
7.
Clavel M, Catimel G (1993) Breast cancer: Chemotherapy in the treatment of advanced disease. Eur J Cancer 29A:598–604PubMedCrossRef
8.
Fisher B, Brown A, Mamounas E et al (1997) Effect of preoperative chemotherapy on loco-regional disease in women with operable breast cancer: Findings from National Surgical Adjuvant Breast and Bowel Project B-18. J Clin Oncol 15:2483–2493PubMed
9.
Heys SD, Eremin JM, Sarkar TK et al (1994) Role of multimodality therapy in the management of locally advanced carcinoma of the breast. J Am Coll Surg 179:493–504PubMed
10.
Frei E III, Canellos GP (1980) Dose, a critical factor in cancer chemotherapy. Am J Med 69:585–594PubMedCrossRef
11.
Miller AB, Hoogstraten B, Staquet M, Winkler A (1981) Reporting results of cancer treatment. Cancer 47:207–214PubMedCrossRef
12.
Therasse P, Arbuck SG, Eisenhauer EA et al (2000) New guidelines to evaluate the response to treatment in solid tumors. J Natl Cancer Inst 92:205–216PubMedCrossRef
13.
Price P, Jones T (1995) Can Positron Emission Tomography be used to assess subclinical response to cancer therapy? The EC PET Oncology Concerted action and the EORTC PET study. Eur J Cancer 31A:1924–1927PubMedCrossRef
14.
Wahl RL, Zasadny K, Helvie M, Hutchins GD, Weber B, Cody R (1993) Metabolic monitoring of breast cancer chemohormonotherapy using positron emission tomography: initial evaluation. J Clin Oncol 11:2101–2111PubMed
15.
Bassa P, Kim E, Inoue T et al (1996) Evaluation of preoperative chemotherapy using PET with Fluorine-18 fluorodeoxyglucose in breast cancer. J Nucl Med 37:931–938PubMed
16.
Schelling M, Avril N, Nahrig J et al (2000) Positron emission tomography using [18F]fluorodeoxyglucose for monitoring primary chemotherapy in breast cancer. J Clin Oncol 18:1689–1695PubMed
17.
Rousseau C, Devillers A, Sagan C, Ferrer L, Bridji B, Campion L (2006) Monitoring of early response to neoadjuvant chemotherapy in stage II and III breast cancer by [18F]fluorodeoxyglucose positron emission tomography. J Clin Oncol 24:5366–5372PubMedCrossRef
18.
Sataloff DM, Mason BA, Prestipino AJ et al (1995) Pathologic response to induction chemotherapy in locally advanced carcinoma of the breast: A determinant of outcome. J Am Coll Surg 180:297–306PubMed
19.
Smith IC, Welch AE, Hutcheon AW et al (2000) Positron emission tomography using (18F)-fluorodeoxy-D-glucose to predict the pathologic response of breast cancer to primary chemotherapy. J Clin Oncol 18:1676–1688PubMed
20.
Jansson T, Westlin JE, Ahlstrom H et al (1996) Positron emission tomography studies in patients with locally advanced and/or metastatic breast cancer: a method for early therapy evaluation? J Nucl Med 13:931–938
21.
Mankoff DA, Dunnwald LK, Gralow JR et al (2003) Changes in blood flow and metabolism in locally advanced breast cancer treated with neoadjuvant chemotherapy. J Nucl Med 44:1806–1814PubMed
22.
Bruce DM, Evans NT, Heys SD et al (1995) Positron emission tomography: 2-deoxy-2 [18F]-fluoro-D-glucose uptake in locally advanced breast cancers. Eur J Surg Oncol 21:280–283PubMedCrossRef
23.
Tiling R, Linke R, Untch M et al (2001) 18F-FDG PET and 99mTcsestamibi scintimammography for monitoring breast cancer response to neoadjuvant chemotherapy: a comparative study. Eur J Nucl Med 28:711–720PubMedCrossRef
24.
Kim SJ, Kim SK, Lee ES, Ro J, Kang SH (2004) Predictive value of [18F] FDG PET for pathological response of breast cancer to neo-adjuvant chemotherapy. Ann of Oncol 15:1352–1357CrossRef
25.
Pio BS, Park CK, Pietras R et al (2006) Usefulness of 3′-[F-18] fluoro-3′-deoxythymidine with positron emission tomography in predicting breast cancer response to therapy. Mol Imaging Biol 8:36–42PubMedCrossRef
26.
Kenny L, Coombes RC, Vigushin DM, Al-Nahhas A, Shousha S, Aboagye EO (2007) Imaging early changes in proliferation at 1 week post chemotherapy: a pilot study in breast cancer patients with 3′-deoxy-3′-[18F]fluorothymidine positron emission tomography. Eur J Nucl Med Mol Imaging 34(9):1339–1347PubMedCrossRef
27.
McDermott GM, Welch A, Staff RT et al (2007) Monitoring primary breast cancer throughout chemotherapy using FDG-PET. Breast Cancer Res Treat 102(1):75–84PubMedCrossRef
28.
Li D, Yao Q, Li L, Wang L, Chen J (2007) Correlation between hybrid 18F-FDG PET/CT and apoptosis induced by neoadjuvant chemotherapy in breast cancer. Cancer Biol Ther 6:1442–1448PubMedCrossRef
29.
Meisamy S, Bolan PJ, Baker EH et al (2004) Neoadjuvant chemotherapy of locally advanced breast cancer: predicting response with in vivo (1)H MR spectroscopy— a pilot study at 4 T. Radiology 233(2):424–431PubMedCrossRef
Metadata
Title
The role of 18F-FDG PET/CT in evaluation of early response to neoadjuvant chemotherapy in patients with locally advanced breast cancer
Authors
Amandeep Kumar
Rakesh Kumar
Vathalaru Seenu
Sidharatha Datta Gupta
Madhavi Chawla
Arun Malhotra
Sada Nand Mehta
Publication date
01-06-2009
Publisher
Springer-Verlag
Published in
European Radiology / Issue 6/2009
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-009-1303-z

Other articles of this Issue 6/2009

European Radiology 6/2009 Go to the issue

Magnetic Resonance

Diffusion tensor tractography of the somatosensory system in the human brainstem: initial findings using high isotropic spatial resolution at 3.0 T

Contrast Media

Long-term retention of gadolinium in the skin of rodents following the administration of gadolinium-based contrast agents

Interventional

Comparison of four embolic materials for portal vein embolization: experimental study in pigs

Interventional

Coil embolization of cavernous sinus in patients with direct and dural arteriovenous fistula

Gastrointestinal

Inter-observer agreement for abdominal CT in unselected patients with acute abdominal pain

Breast

Appearence of breast masses on sonoelastography with special focus on the diagnosis of fibroadenomas