European Radiology

, Volume 22, Issue 1, pp 18–25

Comparison of diffusion-weighted MR imaging and FDG PET/CT to predict pathological complete response to neoadjuvant chemotherapy in patients with breast cancer

  • Sang Hee Park
  • Woo Kyung Moon
  • Nariya Cho
  • Jung Min Chang
  • Seock-Ah Im
  • In Ae Park
  • Keon Wook Kang
  • Wonshik Han
  • Dong-Young Noh
Breast

DOI: 10.1007/s00330-011-2236-x

Cite this article as:
Park, S.H., Moon, W.K., Cho, N. et al. Eur Radiol (2012) 22: 18. doi:10.1007/s00330-011-2236-x

Abstract

Objective

To compare the use of diffusion-weighted MR imaging (DWI) and 18F-FDG PET/CT to predict pathological complete response (pCR) in breast cancer patients receiving neoadjuvant chemotherapy.

Methods

Thirty-four women with 34 invasive breast cancers underwent DWI and PET/CT before and after chemotherapy and before surgery. The percentage changes in the apparent diffusion coefficient (ADC) and the standardised uptake value (SUV) were calculated, and the diagnostic performances for predicting pCR were evaluated using receiver operating characteristic (ROC) curve analysis.

Results

After surgery, 7/34 patients (20.6%) were found to have pCR. Az values for DWI, PET/CT and the combined use of DWI and PET/CT were 0.910, 0.873 and 0.944, respectively. The best cut-offs for differentiating pCR from non-pCR were a 54.9% increase in the ADC and a 63.9% decrease in the SUV. DWI showed 100% (7/7) sensitivity and 70.4% (19/27) specificity and PET/CT showed 100% sensitivity and 77.8% (21/27) specificity. When DWI and PET/CT were combined, there was a trend towards improved specificity compared with DWI.

Conclusions

DWI and FDG PET/CT show similar diagnostic accuracy for predicting pCR to neoadjuvant chemotherapy in breast cancer patients. The combined use of DWI and FDG PET/CT has the potential to improve specificity in predicting pCR.

Key Points

DWI breast MR and PET/CT show similar accuracy for predicting pathological response

The combined use of DWI and PET/CT can potentially improve specificity

This can assist individualised treatment in breast cancer patients receiving neoadjvant chemotherapy

Keywords

Breast cancerChemotherapyDiffusion-weighted imagingFDG PETPET/CT

Copyright information

© European Society of Radiology 2011

Authors and Affiliations

  • Sang Hee Park
    • 1
  • Woo Kyung Moon
    • 1
  • Nariya Cho
    • 1
  • Jung Min Chang
    • 1
  • Seock-Ah Im
    • 2
  • In Ae Park
    • 3
  • Keon Wook Kang
    • 4
  • Wonshik Han
    • 5
  • Dong-Young Noh
    • 5
  1. 1.Department of RadiologySeoul National University HospitalSeoulSouth Korea
  2. 2.Department of Internal MedicineSeoul National University HospitalSeoulSouth Korea
  3. 3.Department of PathologySeoul National University HospitalSeoulSouth Korea
  4. 4.Department of Nuclear MedicineSeoul National University HospitalSeoulSouth Korea
  5. 5.Department of SurgerySeoul National University HospitalSeoulSouth Korea