title: Can positron emission tomography/computed tomography with the dual tracers fluorine-18 fluoroestradiol and fluorodeoxyglucose predict neoadjuvant chemotherapy response of breast cancer?--A pilot study.
abstract: OBJECTIVE
  To assess the clinical value of dual tracers Positron emission tomography/computed tomography (PET/CT) (18)F-fluoroestradiol ((18)F-FES) and (18)F-fluorodeoxyglucose ((18)F-FDG) in predicting neoadjuvant chemotherapy response (NAC) of breast cancer.
  
  
  METHODS
  Eighteen consecutive patients with newly diagnosed, non-inflammatory, stage II and III breast cancer undergoing NAC were included. Before chemotherapy, they underwent both (18)F-FES and (18)F-FDG PET/CT scans. Surgery was performed after three to six cycles of chemotherapy. Tumor response was graded and divided into two groups: the responders and non-responders. We used the maximum standardized uptake value (SUVmax) to qualify each primary lesion.
  
  
  RESULTS
  Pathologic analysis revealed 10 patients were responders while the other 8 patients were non-responders. There was no statistical difference of SUVmax-FDG and tumor size between these two groups (P>0.05). On the contrary, SUVmax-FES was lower in responders (1.75±0.66 versus 4.42±1.14; U=5, P=0.002); and SUVmax-FES/FDG also showed great value in predicting outcome (0.16±0.06 versus 0.54±0.22; U=5, P=0.002).
  
  
  CONCLUSIONS
  Our study showed (18)F-FES PET/CT might be feasible to predict response of NAC. However, whether the use of dual tracers (18)F-FES and (18)F-FDG has complementary value should be further studied.
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Zhongyi
authors.initials: Z
authors.lastname: Yang
authors.forename: Yifei
authors.initials: Y
authors.lastname: Sun
authors.forename: Jing
authors.initials: J
authors.lastname: Xue
authors.forename: Zhifeng
authors.initials: Z
authors.lastname: Yao
authors.forename: Junyan
authors.initials: J
authors.lastname: Xu
authors.forename: Jingyi
authors.initials: J
authors.lastname: Cheng
authors.forename: Wei
authors.initials: W
authors.lastname: Shi
authors.forename: Beiling
authors.initials: B
authors.lastname: Zhu
authors.forename: Yongping
authors.initials: Y
authors.lastname: Zhang
authors.forename: Yingjian
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000628:therapy; D017024:Chemotherapy, Adjuvant / Q000379:methods; D004958:Estradiol / Q000008:administration & dosage*; D005260:Female; D005461:Fluorine / Q000008:administration & dosage*; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage*; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010865:Pilot Projects; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005461:Fluorine; D004958:Estradiol