Usefulness of Combined Metabolic-Volumetric Indices of 18F-FDG PET/CT for the Early Prediction of Neoadjuvant Chemotherapy Outcomes in Breast Cancer

被引：36
作者：
Im H.-J. [1 ,5 ]
Kim Y.K. [1 ,2 ]
Kim Y.-I. [1 ,5 ]
Lee J.J. [4 ]
Lee W.W. [1 ,3 ]
Kim S.E. [1 ,3 ]
机构：
[1] Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul
[2] Department of Nuclear Medicine, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, 156-707, Borame-gil 41, Dongjak-gu
[3] Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggyi
[4] Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
[5] Department of Molecular Medicine and Biopharmaceutical Sciences, WCU Graduate School of Convergence Science and Technology, Seoul National University, Seoul
来源：
Nuclear Medicine and Molecular Imaging | 2013年 / 47卷 / 1期
基金：
新加坡国家研究基金会;
关键词：
Breast cancer; Metabolic tumor volume; Neoadjuvant chemotherapy; Total lesion glycolysis;
D O I：
10.1007/s13139-012-0181-5
中图分类号：
学科分类号：
摘要：
Purpose: The purpose of this study was to investigate the usefulness of metabolic-volumetric indices of 18F- fluorodeoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) for the evaluation of neoadjuvant chemotherapy outcomes in breast cancer. Methods: Twenty-four patients with locally advanced breast cancer were enrolled in the study. They underwent baseline 18F-FDG PET/CT scan and received four or six cycles of neoadjuvant chemotherapy, interim 18F-FDG PET/CT was done after second cycle of chemotherapy. Maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary lesions were calculated. Reduction rates of these parameters were obtained between baseline and interim 18F-FDG PET/CT. Chemotherapy outcomes were assessed using tumor size reduction rate and histological grading system (Miller and Payne system). Reduction rates of SUVmax, MTV, and TLG correlated with chemotherapy outcomes. Results: MTV and TLG reduction rates showed significant correlation with tumor size reduction rate (R = 0. 68, P = 0. 0004; R = 0. 62, P = 0. 002, respectively). However, SUVmax reduction rate showed no significant correlation. MTV and TLG reduction rates were significantly higher in responders than nonresponders, as determined by Miller and Payne system (P < 0. 0007, P < 0. 002). However, SUVmax reduction rate showed no significant difference. On ROC analysis, the area under the MTV and TLG curves was 0. 886, and that of SUVmax was 0. 743. Sensitivity, specificity, positive predictive value, and negative predictive value to predict histopathologic response were the same for MTV and TLG, and the values were 100 %, 85. 7 %, 83. 3 %, and 100 %, respectively (at the reduction rate of 93. 2 % for MTV, and 95. 8 % for TLG). Conclusion: Changes of metabolic-volumetric indices successfully reflected the neoadjuvant chemotherapy outcomes. MTV and TLG could be robust indices in discriminating pathologic responder as SUVmax, after neoadjuvant chemotherapy. © 2012 Korean Society of Nuclear Medicine.
引用
收藏
页码：36 / 43
页数：7
相关论文
共 26 条
[1]  
Jemal A., Siegel R., Xu J., Ward E., Cancer statistics, 2010, CA Cancer J Clin., 60, pp. 277-300, (2010)
[2]  
Giordano S.H., Update on locally advanced breast cancer, Oncologist, 8, pp. 521-530, (2003)
[3]  
Groheux D., Giacchetti S., Espie M., Rubello D., Moretti J.L., Hindie E., Early monitoring of response to neoadjuvant chemotherapy in breast cancer with (18)F-FDG PET/CT: defining a clinical aim, Eur J Nucl Med Mol Imaging., 38, pp. 419-425, (2011)
[4]  
Rousseau C., Devillers A., Sagan C., Ferrer L., Bridji B., Campion L., Et al., Monitoring of early response to neoadjuvant chemotherapy in stage II and III breast cancer by [18F]fluorodeoxyglucose positron emission tomography, J Clin Oncol, 24, pp. 5366-5372, (2006)
[5]  
Westerterp M., van Westreenen H.L., Reitsma J.B., Hoekstra O.S., Stoker J., Fockens P., Et al., Esophageal cancer: CT, endoscopic US, and FDG PET for assessment of response to neoadjuvant therapy-systematic review, Radiology, 236, pp. 841-851, (2005)
[6]  
Kalff V., Duong C., Drummond E.G., Matthews J.P., Hicks R.J., Findings on 18F-FDG PET scans after neoadjuvant chemoradiation provides prognostic stratification in patients with locally advanced rectal carcinoma subsequently treated by radical surgery, J Nucl Med, 47, pp. 14-22, (2006)
[7]  
Wahl R.L., Zasadny K., Helvie M., Hutchins G.D., Weber B., Cody R., Metabolic monitoring of breast cancer chemohormonotherapy using positron emission tomography: initial evaluation, J Clin Oncol, 11, pp. 2101-2111, (1993)
[8]  
Schwarz-Dose J., Untch M., Tiling R., Sassen S., Mahner S., Kahlert S., Et al., Monitoring primary systemic therapy of large and locally advanced breast cancer by using sequential positron emission tomography imaging with [18F]fluorodeoxyglucose, J Clin Oncol, 27, pp. 535-541, (2009)
[9]  
Kumar A., Kumar R., Seenu V., Gupta S.D., Chawla M., Malhotra A., Et al., The role of 18F-FDG PET/CT in evaluation of early response to neoadjuvant chemotherapy in patients with locally advanced breast cancer, Eur Radiol, 19, pp. 1347-1357, (2009)
[10]  
Duch J., Fuster D., Munoz M., Fernandez P.L., Paredes P., Fontanillas M., Et al., 18F-FDG PET/CT for early prediction of response to neoadjuvant chemotherapy in breast cancer, Eur J Nucl Med Mol Imaging, 36, pp. 1551-1557, (2009)
123