title: 18F-fluorodeoxyglucose positron emission tomography optimizes neoadjuvant chemotherapy for primary breast cancer to achieve pathological complete response.
abstract: BACKGROUND
  To assess the usefulness of positron emission tomography combined with computed tomography using (18)F-fluorodeoxyglucose (FDG PET/CT) for optimizing chemotherapy during neoadjuvant chemotherapy for primary breast cancer.
  
  
  METHODS
  One hundred and eight patients (110 tumors) with breast cancer (≥2 cm, stages II and III) received neoadjuvant chemotherapy consisting of an anthracycline-based regimen and taxane. The maximal value of the baseline standardized uptake value (SUV) and the change in SUV after four cycles of an anthracycline-based regimen relative to baseline SUV were assessed for predicting pathological complete response (pCR) after sequential taxane.
  
  
  RESULTS
  Tumors with pCR had significantly higher baseline SUV (9.3 ± 3.7 SD) compared to those with non-pCR (7.2 ± 3.8 SD) (p = 0.02), but there was a considerable overlap between two groups. On PET scan after four cycles of chemotherapy, thirty-three patients (33.7%) with a 72.1% or greater reduction in SUV were considered as responders and the performance in predicting pCR had a sensitivity of 88.9% and specificity of 78.7%.
  
  
  CONCLUSIONS
  The baseline SUV could not be a useful indicator for predicting pCR due to the wide range in sensitivity. On the other hand, a relative change in SUV after completion of an anthracycline-based regimen could be useful for predicting pCR.
authors.affiliation: Medical Service School, National Defense Force, 1-2-24 Ikejiri, Setagaya-ku, Tokyo, 154-0001, Japan.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Ueda
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Saeki
authors.forename: Takashi
authors.initials: T
authors.lastname: Shigekawa
authors.forename: Jiro
authors.initials: J
authors.lastname: Omata
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Moriya
authors.forename: Junji
authors.initials: J
authors.lastname: Yamamoto
authors.forename: Akihiko
authors.initials: A
authors.lastname: Osaki
authors.forename: Nobuko
authors.initials: N
authors.lastname: Fujiuchi
authors.forename: Misono
authors.initials: M
authors.lastname: Misumi
authors.forename: Hideki
authors.initials: H
authors.lastname: Takeuchi
authors.forename: Takaki
authors.initials: T
authors.lastname: Sakurai
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tsuda
authors.forename: Katsumi
authors.initials: K
authors.lastname: Tamura
authors.forename: Jiro
authors.initials: J
authors.lastname: Ishida
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Abe
authors.forename: Etsuko
authors.initials: E
authors.lastname: Imabayashi
authors.forename: Ichiei
authors.initials: I
authors.lastname: Kuji
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsuda
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D001952:Bridged-Ring Compounds / Q000627:therapeutic use*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D043823:Taxoids / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents; D001952:Bridged-Ring Compounds; D019275:Radiopharmaceuticals; D043823:Taxoids; D019788:Fluorodeoxyglucose F18; C080625:taxane