Sequential 18F-FDG PET/CT for early prediction of complete pathological response in breast and axilla during neoadjuvant chemotherapy
Sequential 18F-FDG PET/CT for early prediction of complete pathological response in breast and axilla during neoadjuvant chemotherapy
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DOI：
10.1007/s00259-013-2515-7
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发表时间：
2014-01-01
影响因子：
9.1
通讯作者：
Olmos, Renato A. Valdes
中科院分区：
文献类型：
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作者：
Koolen, Bas B.;Pengel, Kenneth E.;Olmos, Renato A. Valdes
为了研究在新辅助化疗（NAC）期间，在原发肿瘤和腋窝淋巴结中连续PET/CT扫描的反应监测对预测完全病理学反应（pCR）的价值，同时考虑乳腺癌亚型。在107例连续患者中，基线时进行了290次PET/CT扫描化疗后2 - 3周（PET/CT 1，107例患者）、化疗后2 - 3周（PET/CT 2，85例患者）和化疗后6 - 8周（PET/CT 3，98例患者）。SUVmax的相对变化（相对于基线）的肿瘤和淋巴结以及两者的组合（logistic回归后），以及扫描之间最高SUV最大值的变化（肿瘤或淋巴结），并使用受试者操作特征（ROC）分析评估其与NAC完成后肿瘤和淋巴结pCR的相关性。65%）、1例ER阳性/HER 2阴性肿瘤（2%）和16例三阴性肿瘤（52%）。预测3周后HER 2阳性肿瘤中pCR的ROC曲线下面积（ROC-AUC）对于肿瘤的相对变化为0.61，对于肿瘤和淋巴结的组合变化为0.67，对于扫描之间最高SUVmax的变化为0.72。8周后，等效值分别为0.59、0.42和0.64。在三阴性肿瘤中，ROC-AUC在2周后分别为0.76、0.84和0.76，在6周后分别为0.87、0.93和0.88。在HER 2阳性肿瘤中，3周或8周后的PET/CT扫描似乎都没有用。肿瘤和腋窝淋巴结的SUVmax变化与pCR最相关。
To investigate the value of response monitoring in both the primary tumour and axillary nodes on sequential PET/CT scans during neoadjuvant chemotherapy (NAC) for predicting complete pathological response (pCR), taking the breast cancer subtype into account.In 107 consecutive patients 290 PET/CT scans were performed at baseline (PET/CT1, 107 patients), after 2 - 3 weeks of chemotherapy (PET/CT2, 85 patients), and after 6 - 8 weeks (PET/CT3, 98 patients). The relative changes in SUVmax (from baseline) of the tumour and the lymph nodes and in both combined (after logistic regression), and the changes in the highest SUVmax between scans (either tumour or lymph node) were determined and their associations with pCR of the tumour and lymph nodes after completion of NAC were assessed using receiver operating characteristic (ROC) analysis.A pCR was seen in 17 HER2-positive tumours (65 %), 1 ER-positive/HER2-negative tumour (2 %), and 16 triple-negative tumours (52 %). The areas under the ROC curves (ROC-AUC) for the prediction of pCR in HER2-positive tumours after 3 weeks were 0.61 for the relative change in tumours, 0.67 for the combined change in tumour and nodes, and 0.72 for the changes in the highest SUVmax between scans. After 8 weeks equivalent values were 0.59, 0.42 and 0.64, respectively. In triple-negative tumours the ROC-AUCs were 0.76, 0.84 and 0.76 after 2 weeks, and 0.87, 0.93 and 0.88 after 6 weeks, respectively.In triple-negative tumours a PET/CT scan after 6 weeks (three cycles) appears to be optimally predictive of pCR. In HER2-positive tumours neither a PET/CT scan after 3 weeks nor after 8 weeks seems to be useful. The changes in SUVmax of both the tumour and axillary nodes combined correlates best with pCR.