6533b82cfe1ef96bd128eb29

RESEARCH PRODUCT

[18F]FDG-PET predicts complete pathological response of breast cancer to neoadjuvant chemotherapy

Jean-marc RiedingerFrançois BrunotteChristophe BoichotLaurent ArnouldAlina Berriolo-riedingerAlexandre CochetBruno CoudertClaude TouzeryMichel ToubeauPierre Fumoleau

subject

Oncologymedicine.medical_specialtymedicine.medical_treatmentPathological responseAntineoplastic AgentsBreast Neoplasms[SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicineSensitivity and Specificity030218 nuclear medicine & medical imaging18f fdg pet[SDV.IB.MN] Life Sciences [q-bio]/Bioengineering/Nuclear medicine[ SDV.IB.MN ] Life Sciences [q-bio]/Bioengineering/Nuclear medicine03 medical and health sciences0302 clinical medicineBreast cancerFluorodeoxyglucose F18Internal medicinemedicineHumansRadiology Nuclear Medicine and imagingNeoadjuvant therapyComputingMilieux_MISCELLANEOUSChemotherapymedicine.diagnostic_testbusiness.industryFdg uptakeReproducibility of ResultsGeneral MedicineMiddle Agedmedicine.diseasePrognosisNeoadjuvant Therapy3. Good healthClinical trialTreatment OutcomePositron emission tomography030220 oncology & carcinogenesisPositron-Emission TomographyFemaleRadiopharmaceuticalsbusiness

description

To evaluate, in breast cancer patients treated by neoadjuvant chemotherapy, the predictive value of reduction in FDG uptake with regard to complete pathological response (pCR).Forty-seven women with non-metastatic, non-inflammatory, large or locally advanced breast cancer were included. Tumour uptake of FDG was evaluated before and after the first course of neoadjuvant chemotherapy. Four indices were used: maximal and average SUV without or with correction by body surface area and glycaemia (SUV(max), SUV(avg), SUV(max-BSA-G) and SUV(avg-BSA-G), respectively). The predictive value of reduction in FDG uptake with respect to pCR was studied by logistic regression analysis. Relationships between baseline [(18)F]FDG uptake and prognostic parameters were assessed.The relative decrease in FDG uptake (DeltaSUV) after the first course of neoadjuvant chemotherapy was significantly greater in the pCR group than in the non-pCR group (p0.000066). The four FDG uptake indices were all strongly correlated with each other. A decrease in SUV(max-BSA-G) of 85.4% +/- 21.9% was found in pCR patients, versus 22.6% +/- 36.6% in non-pCR patients. DeltaSUV(max-BSA-G)-60% predicted the pCR with an accuracy of 87% and DeltaSUVs were found to be only factors predictive of the pCR at multivariate analysis. An elevated baseline SUV was associated with high mitotic activity (p0.0016), tumour grading (p0.004), high nuclear pleomorphism score (p0.03) and negative hormonal receptor status (p0.005).In breast cancer patients, after only one course of neoadjuvant chemotherapy the reduction in FDG uptake is an early and powerful predictor of pCR.

https://hal.archives-ouvertes.fr/hal-00821304