Measuring response to chemotherapy in locally advanced breast cancer: methodological considerations.
In this review the findings of response monitoring studies in breast cancer, using [(18)F]2-fluoro-2-deoxy-D-glucose (FDG) and positron emission tomography (PET), are summarised. These studies indicate that there is a strong relationship between response and decrease in FDG signal even at an early stage of therapy. The review concentrates on methodological aspects of monitoring response with FDG: timing of serial scans, approach to region of interest definition, method of quantification and pitfalls of FDG. It is argued that, for clinical applications, there is now a need to standardise methodology. This would be necessary to establish firm cut-off values for discriminating responders from non-responders, which in turn would provide a means for providing optimal treatment for as many patients as possible.
Krak
Nanda C
NC
Department of Nuclear Medicine and PET Research, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
Hoekstra
Otto S
OS
Lammertsma
Adriaan A
AA
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D020000:Decision Support Systems, Clinical; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D011379:Prognosis; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods* / Q000592:standards; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18