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99mTc-3PRGD2 SPECT to monitor early response to neoadjuvant chemotherapy in stage II and III breast cancer

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Monitoring of response to neoadjuvant chemotherapy (NCT) is important for optimal management of patients with breast cancer. 99mTc-3PRGD2 SPECT is a newly developed imaging modality for evaluating tumor vascular status. In this study, we investigated the application of 99mTc-3PRGD2 SPECT in evaluating therapy response to NCT in patients with stage II or III breast cancer.

Methods

Thirty-three patients were scheduled to undergo 99mTc-3PRGD2 SPECT at baseline, after the first and second cycle of NCT. Four patients had extremely low 99mTc-3PRGD2 uptake at baseline, and were not included in the subsequent studies. Changes in tumor to nontumor (T/N) ratio were compared with pathological tumor responses classified using the residual cancer burden system. Receiver operator characteristic analysis was used to compare the power to identify responders between the end of the first and the end of the second cycle of NCT. The impact of breast cancer subtype on 99mTc-3PRGD2 uptake was evaluated. The correlation between 99mTc-3PRGD2 uptake and pathological tumor response was also evaluated in each breast cancer subtype.

Results

Surgery was performed after four cycles of NCT and pathological analysis revealed 18 responders and 15 nonresponders. In patients with clearly visible 99mTc-3PRGD2 uptake at baseline, the sensitivity, specificity, and negative predictive value of 99mTc-3PRGD2 SPECT were 86.7 %, 85.7 % and 86.7 % after the first cycle of NCT, and 92.9 %, 93.3 % and 93.3 % after the second cycle, respectively. Among these patients, the HER-2-positive group demonstrated both higher T/N ratios and a greater change in T/N ratio than patients with other breast cancer subtypes (P < 0.05). A strong correlation was found between changes in T/N ratio and pathological tumor response in the HER-2-positive group (P < 0.03).

Conclusion

99mTc-3PRGD2 SPECT seems to be useful for determining the pathological tumor response in patients with stage II or III breast cancer undergoing NCT, especially those with the HER-2-positive subtype.

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Acknowledgments

This study was funded by the National Natural Science Foundation of China (NSFC) projects (grant number 81271606), Research Fund of Science and Technology Department of Jilin Province (grant number 20150520154JH).

Compliance with ethical standards

ᅟ

Conflicts of interest

None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, China-Japan Union Hospital of Jilin University, Changchun, 130033, China

    Bin Ji, Bin Chen, Ting Wang, Minglong Chen, Tiefeng Ji, Shi Gao & Qingjie Ma

  2. Department of Breast Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130033, China

    Yan Song

  3. Department of Pathology, China-Japan Union Hospital of Jilin University, Changchun, 130033, China

    Xueju Wang

Authors
  1. Bin Ji
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  2. Bin Chen
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  4. Yan Song
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  6. Tiefeng Ji
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  7. Xueju Wang
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  8. Shi Gao
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  9. Qingjie Ma
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Corresponding authors

Correspondence to Shi Gao or Qingjie Ma.

Additional information

Bin Ji and Bin Chen contributed equally to this work.

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Ji, B., Chen, B., Wang, T. et al. 99mTc-3PRGD2 SPECT to monitor early response to neoadjuvant chemotherapy in stage II and III breast cancer. Eur J Nucl Med Mol Imaging 42, 1362–1370 (2015). https://doi.org/10.1007/s00259-015-3062-1

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