Early prediction of pathological complete response in luminal B type neoadjuvant chemotherapy-treated breast cancer patients: Comparison between interim 18 F-FDG PET/CT and MRI

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Abstract

Purpose The aim of this study is to justify the effectiveness of interim PET/computed tomography (CT) for predicting pathological complete response (pCR) in luminal B type breast cancer patients and to compare the diagnostic performance of interim PET/CT and MRI. Materials and methods Twenty-one patients with neoadjuvant chemotherapy (NAC)-treated luminal B type breast cancer were included. All patients underwent PET/CT and MRI at baseline and interim (mid-point). Breast surgery was performed after completion of NAC. Maximum standardized uptake values (SUV max) of breast malignant lesions in each PET/CT scan were acquired in each patient. The metabolic response was calculated as follows: ΔSUV (%)=(baseline SUV max -interim SUV max)/baseline SUV max ×100 (%). In MRI, the relative size change was calculated as follows: Size change (%)=longest diameter interim MRI-longest diameter baseline MRI/longest diameter baseline MRI×100 (%). pCR was concluded through the final pathologic specimen after breast surgery. The receiver-operating characteristic analysis was used as a statistical method. Results Of 21 patients, seven achieved a pCR after surgery. In PET/CT, an optimal cut-off ΔSUV (%) of 69.0% was proposed with a sensitivity of 85.7% and a specificity of 100% (P<0.0001). In MRI, an optimal cut-off size change (%) was 38.2% with a sensitivity of 64.3% and a specificity of 71.4% (P=0.29). The area under the curve was 0.92 and 0.65, respectively. PET/CT presented better predictability of the pCR than MRI (P=0.04). Conclusion In luminal B type NAC-treated breast cancer patients, it is possible to use PET/CT as an early surrogate marker for predicting pCR and it is significantly more predictable for pCR than MRI.

Original languageEnglish
Pages (from-to)887-891
Number of pages5
JournalNuclear Medicine Communications
Volume36
Issue number9
DOIs
Publication statusPublished - 2015 Aug 8

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Tomography
Breast Neoplasms
Drug Therapy
Breast
ROC Curve
Area Under Curve
Biomarkers

Keywords

  • 18 F-FDG PET
  • breast cancer
  • luminal B type
  • MRI
  • neoadjuvant chemotherapy
  • PET/CT
  • response

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{67d06dcc22d84422bf18fb54160ab05f,
title = "Early prediction of pathological complete response in luminal B type neoadjuvant chemotherapy-treated breast cancer patients: Comparison between interim 18 F-FDG PET/CT and MRI",
abstract = "Purpose The aim of this study is to justify the effectiveness of interim PET/computed tomography (CT) for predicting pathological complete response (pCR) in luminal B type breast cancer patients and to compare the diagnostic performance of interim PET/CT and MRI. Materials and methods Twenty-one patients with neoadjuvant chemotherapy (NAC)-treated luminal B type breast cancer were included. All patients underwent PET/CT and MRI at baseline and interim (mid-point). Breast surgery was performed after completion of NAC. Maximum standardized uptake values (SUV max) of breast malignant lesions in each PET/CT scan were acquired in each patient. The metabolic response was calculated as follows: ΔSUV ({\%})=(baseline SUV max -interim SUV max)/baseline SUV max ×100 ({\%}). In MRI, the relative size change was calculated as follows: Size change ({\%})=longest diameter interim MRI-longest diameter baseline MRI/longest diameter baseline MRI×100 ({\%}). pCR was concluded through the final pathologic specimen after breast surgery. The receiver-operating characteristic analysis was used as a statistical method. Results Of 21 patients, seven achieved a pCR after surgery. In PET/CT, an optimal cut-off ΔSUV ({\%}) of 69.0{\%} was proposed with a sensitivity of 85.7{\%} and a specificity of 100{\%} (P<0.0001). In MRI, an optimal cut-off size change ({\%}) was 38.2{\%} with a sensitivity of 64.3{\%} and a specificity of 71.4{\%} (P=0.29). The area under the curve was 0.92 and 0.65, respectively. PET/CT presented better predictability of the pCR than MRI (P=0.04). Conclusion In luminal B type NAC-treated breast cancer patients, it is possible to use PET/CT as an early surrogate marker for predicting pCR and it is significantly more predictable for pCR than MRI.",
keywords = "18 F-FDG PET, breast cancer, luminal B type, MRI, neoadjuvant chemotherapy, PET/CT, response",
author = "Kisoo Pahk and Sungeun Kim and Jae-Gol Choe",
year = "2015",
month = "8",
day = "8",
doi = "10.1097/MNM.0000000000000329",
language = "English",
volume = "36",
pages = "887--891",
journal = "Nuclear Medicine Communications",
issn = "0143-3636",
publisher = "Lippincott Williams and Wilkins",
number = "9",

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TY - JOUR

T1 - Early prediction of pathological complete response in luminal B type neoadjuvant chemotherapy-treated breast cancer patients

T2 - Comparison between interim 18 F-FDG PET/CT and MRI

AU - Pahk, Kisoo

AU - Kim, Sungeun

AU - Choe, Jae-Gol

PY - 2015/8/8

Y1 - 2015/8/8

N2 - Purpose The aim of this study is to justify the effectiveness of interim PET/computed tomography (CT) for predicting pathological complete response (pCR) in luminal B type breast cancer patients and to compare the diagnostic performance of interim PET/CT and MRI. Materials and methods Twenty-one patients with neoadjuvant chemotherapy (NAC)-treated luminal B type breast cancer were included. All patients underwent PET/CT and MRI at baseline and interim (mid-point). Breast surgery was performed after completion of NAC. Maximum standardized uptake values (SUV max) of breast malignant lesions in each PET/CT scan were acquired in each patient. The metabolic response was calculated as follows: ΔSUV (%)=(baseline SUV max -interim SUV max)/baseline SUV max ×100 (%). In MRI, the relative size change was calculated as follows: Size change (%)=longest diameter interim MRI-longest diameter baseline MRI/longest diameter baseline MRI×100 (%). pCR was concluded through the final pathologic specimen after breast surgery. The receiver-operating characteristic analysis was used as a statistical method. Results Of 21 patients, seven achieved a pCR after surgery. In PET/CT, an optimal cut-off ΔSUV (%) of 69.0% was proposed with a sensitivity of 85.7% and a specificity of 100% (P<0.0001). In MRI, an optimal cut-off size change (%) was 38.2% with a sensitivity of 64.3% and a specificity of 71.4% (P=0.29). The area under the curve was 0.92 and 0.65, respectively. PET/CT presented better predictability of the pCR than MRI (P=0.04). Conclusion In luminal B type NAC-treated breast cancer patients, it is possible to use PET/CT as an early surrogate marker for predicting pCR and it is significantly more predictable for pCR than MRI.

AB - Purpose The aim of this study is to justify the effectiveness of interim PET/computed tomography (CT) for predicting pathological complete response (pCR) in luminal B type breast cancer patients and to compare the diagnostic performance of interim PET/CT and MRI. Materials and methods Twenty-one patients with neoadjuvant chemotherapy (NAC)-treated luminal B type breast cancer were included. All patients underwent PET/CT and MRI at baseline and interim (mid-point). Breast surgery was performed after completion of NAC. Maximum standardized uptake values (SUV max) of breast malignant lesions in each PET/CT scan were acquired in each patient. The metabolic response was calculated as follows: ΔSUV (%)=(baseline SUV max -interim SUV max)/baseline SUV max ×100 (%). In MRI, the relative size change was calculated as follows: Size change (%)=longest diameter interim MRI-longest diameter baseline MRI/longest diameter baseline MRI×100 (%). pCR was concluded through the final pathologic specimen after breast surgery. The receiver-operating characteristic analysis was used as a statistical method. Results Of 21 patients, seven achieved a pCR after surgery. In PET/CT, an optimal cut-off ΔSUV (%) of 69.0% was proposed with a sensitivity of 85.7% and a specificity of 100% (P<0.0001). In MRI, an optimal cut-off size change (%) was 38.2% with a sensitivity of 64.3% and a specificity of 71.4% (P=0.29). The area under the curve was 0.92 and 0.65, respectively. PET/CT presented better predictability of the pCR than MRI (P=0.04). Conclusion In luminal B type NAC-treated breast cancer patients, it is possible to use PET/CT as an early surrogate marker for predicting pCR and it is significantly more predictable for pCR than MRI.

KW - 18 F-FDG PET

KW - breast cancer

KW - luminal B type

KW - MRI

KW - neoadjuvant chemotherapy

KW - PET/CT

KW - response

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