[Value of fused 18F-FDG PET/CT images in predicting efficacy of neoadjuvant chemotherapy on breast cancer].
OBJECTIVE
Previous studies confirmed that fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET) imaging relates to clinical or pathologic responses of tumors to neoadjuvant therapy. This study was to evaluate the correlation of fused 18F-FDG PET/CT images to cell apoptosis of breast cancer after neoadjuvant chemotherapy, and explore its value in predicting the efficacy of neoadjuvant chemotherapy on breast cancer.


METHODS
Forty-five patients with primary breast cancer, proven by core needle biopsy, underwent 3 cycles of neoadjuvant chemotherapy. PET/CT was performed before and after treatment, and the ratio of tumor area activity to non-tumor area activity (T/N) was calculated. The apoptosis index (AI) was determined using TUNEL technique.


RESULTS
Of the 45 patients, 4(8.9%) achieved complete remission (CR), 29 (64.4%) achieved partial remission (PR), 10 (22.2%) presented stable disease (SD), and 2 (4.4%) presented progressive disease (PD) after neoadjuvant chemotherapy. The mean T/N ratio was decreased from 3.23+/-0.63 before chemotherapy to 2.31+/-0.49 after chemotherapy (P=0.006) by 6.4%-50.8%. The mean AI was increased from (2.81+/-0.76)% before chemotherapy to (17.31+/-6.85)% after chemotherapy (P<0.001) by 1.9%-41.3%. The T/N ratio reduction rate was positively correlated to AI change (r(s)=0.850, P<0.001). At a threshold of 20% decrease from baseline in T/N ratio, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET/CT in predicting clinical response were 90.9%, 83.3%, 93.8%, 76.9%, and 92.1%, respectively.


CONCLUSIONS
Neoadjuvant chemotherapy might effectively induce cell apoptosis in breast cancer and inhibit the glucose uptake. Fused PET/CT imaging is closely related to cell apoptosis status of breast cancer after neoadjuvant chemotherapy, and may be applied to predict the response of breast cancer to neoadjuvant chemotherapy.
Li
Dong
D
Department of Vascular and Endocrine Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, PR China.
Chen
Jiang-Hao
JH
Wang
Jing
J
Ling
Rui
R
Yao
Qing
Q
Wang
Ling
L
D000328:Adult; D000368:Aged; D017209:Apoptosis; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D020287:In Situ Nick-End Labeling; D008207:Lymphatic Metastasis; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012074:Remission Induction; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18