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Eur J Nucl Med Mol Imaging. 2018;45(3):328-339.

Integrated 18F-FDG PET/MRI in breast cancer: early prediction of response to neoadjuvant chemotherapy.

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제1저자 조나리야 · 교신저자 임석아

PMID 29101445 DOI 10.1007/s00259-017-3849-3 IF 7.6 혈액종양내과
소속 (10)
  1. Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
  2. Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.
  3. Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
  4. Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. moisa@snu.ac.kr.
  5. Cancer Research Institute, Seoul National University, Seoul, Republic of Korea. moisa@snu.ac.kr.
  6. Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.
  7. Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
  8. Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
  9. Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
  10. Department of Radiology, College of Medicine, Yeungnam University, Daegu, Republic of Korea.

Abstract

PURPOSE To explore whether integrated 18F-FDG PET/MRI can be used to predict pathological response to neoadjuvant chemotherapy (NAC) in patients with breast cancer.

METHODS Between November 2014 and April 2016, 26 patients with breast cancer who had received NAC and subsequent surgery were prospectively enrolled. Each patient underwent 18F-FDG PET/MRI examination before and after the first cycle of NAC. Qualitative MRI parameters, including morphological descriptors and the presence of peritumoral oedema were assessed. Quantitatively, PET parameters, including maximum standardized uptake value, metabolic tumour volume and total lesion glycolysis (TLG), and MRI parameters, including washout proportion and signal enhancement ratio (SER), were measured. The performance of the imaging parameters singly and in combination in predicting a pathological incomplete response (non-pCR) was assessed.

RESULTS Of the 26 patients, 7 (26.9%) exhibited a pathological complete response (pCR), and 19 (73.1%) exhibited a non-pCR. No significant differences were found between the pCR and non-pCR groups in the qualitative MRI parameters. The mean percentage reductions in TLG30% on PET and SER on MRI were significantly greater in the pCR group than in the non-pCR group (TLG30% -64.8 ± 15.5% vs. -25.4 ± 48.7%, P = 0.005; SER -34.6 ± 19.7% vs. -8.7 ± 29.0%, P = 0.040). The area under the receiver operating characteristic curve for the percentage change in TLG30% (0.789, 95% CI 0.614 to 0.965) was similar to that for the percentage change in SER (0.789, 95% CI 0.552 to 1.000; P = 1.000).The specificity of TLG30% in predicting pCR) was 100% (7/7) and that of SER was 71.4% (5/7). The sensitivity of TLG30% in predicting non-pCR was 63.2% (12/19) and that of SER was 84.2% (16/19). When the combined TLG30% and SER criterion was applied, sensitivity was 100% (19/19), and specificity was 71.4% (5/7).

CONCLUSION 18F-FDG PET/MRI can be used to predict non-pCR after the first cycle of NAC in patients with breast cancer and has the potential to improve sensitivity by the addition of MRI parameters to the PET parameters.

Keywords

Breast cancerNeoadjuvant chemotherapyPETPET/MRIResponse prediction

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그 밖의 정보
출판 형태
Clinical Trial, Journal Article
저널
European journal of nuclear medicine and molecular imaging · eISSN 1619-7089
전자 출판
2017-11-04
MeSH
Adult · Benzopyrans · Breast Neoplasms / diagnostic imaging / drug therapy · Female · Fluorodeoxyglucose F18* · Humans · Magnetic Resonance Imaging* · Male · Middle Aged · Multimodal Imaging* · Neoadjuvant Therapy* · Neoplasms · Observer Variation · Positron-Emission Tomography* · Treatment Outcome
Substances
Benzopyrans · timefurone · Fluorodeoxyglucose F18
연구비
Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education NRF-2014R1A1A2053682 · Seoul National University Hospital no. 30-2016-0110
참고문헌
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