Combined use of MRI and PET to monitor response and assess residual disease for locally advanced breast cancer treated with neoadjuvant chemotherapy
Combined use of MRI and PET to monitor response and assess residual disease for locally advanced breast cancer treated with neoadjuvant chemotherapy
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DOI：
10.1016/j.acra.2004.07.007
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发表时间：
2004-10-01
影响因子：
4.8
通讯作者：
Livingston, RB
中科院分区：
文献类型：
--
作者：
Chen, XM;Moore, MO;Livingston, RB
理由和目标。本研究的目的是评估磁共振成像（MRI）和正电子发射断层扫描（PET）在监测新辅助化疗治疗的局部晚期乳腺癌（LABC）的反应和评估残留病变方面具有互补性和价值的假设。我们试图确定这两种方式的组合是否比单独使用更准确，并能为患者管理提供更好的指导。在新辅助化疗前后，对15例LABC患者的16个病灶进行了MRI、PET和临床乳腺检查（CBE）评价。治疗前和治疗后MRI和CBE上的最大肿瘤大小以及PET上的标准摄取值（SUV）作为临床缓解分类和残留疾病评估的测量值。病理学评价为大体和镜下病理肿瘤反应和残留病变提供参考。PET正确预测了6例中的5例（83%）缺乏病理反应; CBE正确预测了6例中的1例（17%），MRI正确预测了6例中的0例。当PET预测反应时，MRI在10例病例中的9例（90%）中准确地确定了宏观病理残留病变的范围。治疗后MRI显示完全缓解（CR）8例，大体病理学完全缓解（mCR）8例（100%）。我们的研究表明，MRI和PET的联合使用是互补的，并提供了优于CBE的优势。PET在预测病理无反应方面更准确。MRI显示的完全缓解与大体病理学完全缓解相关性良好。(C)AUR，2004年。
Rationale and Objectives. The purpose of the study was to evaluate the hypothesis that magnetic resonance imaging (MRI) and positron emission tomography (PET) are complementary and valuable in monitoring response and assessing residual disease of locally advanced breast cancer (LABC) treated with neoadjuvant chemotherapy. We sought to determine if the combination of the two modalities was more accurate than either alone and could provide better guidance in patient management.Materials and Methods. Sixteen lesions in 15 women with LABC were evaluated with MRI, PET, and clinical breast examination (CBE) before and after neoadjuvant chemotherapy. The pre- and posttherapy maximal tumor sizes on MRI and CBE and standard uptake values (SUVs) on PET served as the measurements for clinical response classification and residual disease assessment. Pathologic assessment provided the reference for macroscopic and microscopic pathologic tumor response and residual disease.Results. PET correctly predicted lack of pathologic response in five of six cases (83%); CBE predicted correctly in one of six (17%) cases, and MRI predicted correctly in zero of six cases. When PET predicted response, MRI defined the extent of macroscopic pathologic residual disease accurately in 9 of 10 cases (90%). When posttherapy MRI showed complete response (CR) in eight cases, macroscopic pathologic complete response (mCR) was observed in all eight cases (100%).Conclusion. Our study suggests that combined use of MRI and PET is complementary and offers advantages over CBE. PET was more accurate in predicting pathologic nonresponse. Complete response by MRI correlated well with macroscopic pathologic complete response. (C) AUR, 2004.