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The role of 18F-FDG PET/CT in evaluation of early response to neoadjuvant chemotherapy in patients with locally advanced breast cancer

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Abstract

We evaluated the role of 18F-FDG PET/CT for the assessment of response after two cycles of neo-adjuvant chemotherapy (NACT) for breast cancer. Twenty-three women with locally advanced breast cancer were included in this study. Early response to NACT was evaluated after two cycles using clinical examination, CT, and 18F-FDG PET/CT. Final histopathology following surgery after six cycles of NACT served as reference. Baseline PET/CT demonstrated a total of 26 lesions in 23 patients. The size of the primary tumor ranged from 1.90 cm to 11.60 cm, and the maximum value of the standardized uptake value of FDG (SUVmax) ranged from 3.6 to 38.6 (mean, 11.7). Post-chemotherapy PET/CT examinations were done after two cycles of NACT. The size of the primary tumor on follow-up PET/CT examinations ranged from 0.0 cm to 7.6 cm, and SUVmax ranged from 0.0 to 12.0 (mean, 3.96). On clinical, CT, and PET/CT examinations, 50% reduction in the parameters was taken as the cutoff value to differentiate between responders and non-responders. Post-NACT PET/CT demonstrated that 16 patients were responders and 7 non-responders. Among 16 responders on PET/CT scan, 14 were true positive and 2 were false positive when compared with histopathology. Among seven non-responder patients, six were true negative, and one was false negative. The sensitivity, specificity, and accuracy of PET/CT in detecting responders were 93%, 75%, and 87%, respectively. In conclusion, 18F-FDG PET/CT can differentiate responders from non-responders with high accuracy after two cycles of NACT in patients with LABC.

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Authors and Affiliations

  1. Department of Surgical disciplines, All India Institute of Medical Sciences, New Delhi, India

    Amandeep Kumar, Vathalaru Seenu & Sada Nand Mehta

  2. Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India

    Rakesh Kumar, Madhavi Chawla & Arun Malhotra

  3. Department of Pathology, All India Institute of Medical Sciences, New Delhi, India

    Sidharatha Datta Gupta

  4. E-81, Ansari Nagar (east), AIIMS Campus, New Delhi, 110020, India

    Rakesh Kumar

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  1. Amandeep Kumar
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Correspondence to Rakesh Kumar.

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Kumar, A., Kumar, R., Seenu, V. et al. The role of 18F-FDG PET/CT in evaluation of early response to neoadjuvant chemotherapy in patients with locally advanced breast cancer. Eur Radiol 19, 1347–1357 (2009). https://doi.org/10.1007/s00330-009-1303-z

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  • DOI: https://doi.org/10.1007/s00330-009-1303-z

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