European Journal of Nuclear Medicine and Molecular Imaging

, Volume 34, Issue 12, pp 1915–1924

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

  • Alina Berriolo-Riedinger
  • Claude Touzery
  • Jean-Marc Riedinger
  • Michel Toubeau
  • Bruno Coudert
  • Laurent Arnould
  • Christophe Boichot
  • Alexandre Cochet
  • Pierre Fumoleau
  • François Brunotte
Original Article

DOI: 10.1007/s00259-007-0459-5

Cite this article as:
Berriolo-Riedinger, A., Touzery, C., Riedinger, JM. et al. Eur J Nucl Med Mol Imaging (2007) 34: 1915. doi:10.1007/s00259-007-0459-5

Abstract

Purpose

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).

Methods

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 (SUVmax, SUVavg, SUVmax-BSA-G and SUVavg-BSA-G, respectively). The predictive value of reduction in FDG uptake with respect to pCR was studied by logistic regression analysis. Relationships between baseline [18F]FDG uptake and prognostic parameters were assessed.

Results

The relative decrease in FDG uptake (ΔSUV) after the first course of neoadjuvant chemotherapy was significantly greater in the pCR group than in the non-pCR group (p < 0.000066). The four FDG uptake indices were all strongly correlated with each other. A decrease in SUVmax-BSA-G of 85.4% ± 21.9% was found in pCR patients, versus 22.6% ± 36.6% in non-pCR patients. ΔSUVmax-BSA-G <−60% predicted the pCR with an accuracy of 87% and ΔSUVs were found to be only factors predictive of the pCR at multivariate analysis. An elevated baseline SUV was associated with high mitotic activity (p < 0.0016), tumour grading (p < 0.004), high nuclear pleomorphism score (p < 0.03) and negative hormonal receptor status (p < 0.005).

Conclusion

In breast cancer patients, after only one course of neoadjuvant chemotherapy the reduction in FDG uptake is an early and powerful predictor of pCR.

Keywords

18F-fluorodeoxyglucoseBreast cancerPET scanMonitoring therapySUV

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Alina Berriolo-Riedinger
    • 1
    • 5
  • Claude Touzery
    • 1
  • Jean-Marc Riedinger
    • 1
  • Michel Toubeau
    • 1
  • Bruno Coudert
    • 2
  • Laurent Arnould
    • 3
  • Christophe Boichot
    • 1
  • Alexandre Cochet
    • 1
  • Pierre Fumoleau
    • 2
  • François Brunotte
    • 1
    • 4
  1. 1.Department of Nuclear MedicineCentre Georges Francois LeclercDijonFrance
  2. 2.Department of Medical OncologyCentre Georges Francois LeclercDijonFrance
  3. 3.Department of PathologyCentre Georges Francois LeclercDijonFrance
  4. 4.CNRS UMR 5158DijonFrance
  5. 5.1rue du Professeur MarionDijonFrance