18F-Fluorodeoxyglucose positron emission tomography optimizes neoadjuvant chemotherapy for primary breast cancer to achieve pathological complete response

Background To assess the usefulness of positron emission tomography combined with computed tomography using 18 F-fluorodeoxyglucose (FDG PET/CT) for optimizing chemotherapy during neoadjuvant chemotherapy for primary breast cancer. Methods One hundred and eight patients (110 tumors) with breast canc...

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Bibliographic Details
Published in:International journal of clinical oncology 2012-06, Vol.17 (3), p.276-282
Main Authors: Ueda, Shigeto, Saeki, Toshiaki, Shigekawa, Takashi, Omata, Jiro, Moriya, Tomoyuki, Yamamoto, Junji, Osaki, Akihiko, Fujiuchi, Nobuko, Misumi, Misono, Takeuchi, Hideki, Sakurai, Takaki, Tsuda, Hitoshi, Tamura, Katsumi, Ishida, Jiro, Abe, Yoshiyuki, Imabayashi, Etsuko, Kuji, Ichiei, Matsuda, Hiroshi
Format: Article
Language:English
Subjects:
Antineoplastic Agents - therapeutic use
Breast Neoplasms - diagnostic imaging
Breast Neoplasms - drug therapy
Breast Neoplasms - pathology
Bridged-Ring Compounds - therapeutic use
Cancer Research
Female
Fluorodeoxyglucose F18
Humans
Medicine
Medicine & Public Health
Middle Aged
Neoadjuvant Therapy
Oncology
Original Article
Positron-Emission Tomography
Prospective Studies
Radiopharmaceuticals
Surgical Oncology
Taxoids - therapeutic use
Tomography, X-Ray Computed
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Summary:Background To assess the usefulness of positron emission tomography combined with computed tomography using 18 F-fluorodeoxyglucose (FDG PET/CT) for optimizing chemotherapy during neoadjuvant chemotherapy for primary breast cancer. Methods One hundred and eight patients (110 tumors) with breast cancer (≥2 cm, stages II and III) received neoadjuvant chemotherapy consisting of an anthracycline-based regimen and taxane. The maximal value of the baseline standardized uptake value (SUV) and the change in SUV after four cycles of an anthracycline-based regimen relative to baseline SUV were assessed for predicting pathological complete response (pCR) after sequential taxane. Results Tumors with pCR had significantly higher baseline SUV (9.3 ± 3.7 SD) compared to those with non-pCR (7.2 ± 3.8 SD) ( p  = 0.02), but there was a considerable overlap between two groups. On PET scan after four cycles of chemotherapy, thirty-three patients (33.7%) with a 72.1% or greater reduction in SUV were considered as responders and the performance in predicting pCR had a sensitivity of 88.9% and specificity of 78.7%. Conclusion The baseline SUV could not be a useful indicator for predicting pCR due to the wide range in sensitivity. On the other hand, a relative change in SUV after completion of an anthracycline-based regimen could be useful for predicting pCR.
ISSN:1341-9625
1437-7772
DOI:10.1007/s10147-011-0287-2