title: Diagnostic performance of breast-specific gamma imaging in the assessment of residual tumor after neoadjuvant chemotherapy in breast cancer patients.
abstract: To evaluate the diagnostic performance of breast-specific gamma imaging (BSGI) in the assessment of residual tumor after neoadjuvant chemotherapy (NAC) in breast cancer patients, female breast cancer patients who underwent NAC, preoperative (99m)Tc-sestamibi BSGI, and subsequent definitive breast surgery were enrolled retrospectively. The accuracy of BSGI in the assessment of residual tumor presence and residual tumor size was evaluated and compared to that of magnetic resonance imaging (MRI) using pathology results as the gold standard. The sensitivity and specificity of BSGI for residual tumor detection in 122 enrolled patients were 74.0 and 72.2 %, respectively, and were comparable to those of MRI (81.7 and 72.2 %; P > 0.100). The residual tumor size was significantly underestimated by BSGI in the luminal subtype (P = 0.008) and by MRI in the luminal (P < 0.001) and HER2 subtypes (P = 0.032), with a significantly lesser degree of underestimation by BSGI than MRI in both subtypes. In the triple-negative subtype, both BSGI and MRI generated accurate tumor size measurements. The residual cellularity of triple-negative tumors was significantly higher than that of the non-triple-negative tumors (P = 0.017). The diagnostic performance of BSGI in the assessment of residual tumor is comparable to that of MRI in breast cancer patients. The assessment of residual tumor extent by BSGI depends on the molecular subtype, but BSGI may be more accurate than MRI. Underestimation of tumor size in the luminal and/or HER2 subtypes by BSGI and MRI may be due to low-residual cellularity.
authors.affiliation: Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea.
authors.forename: Hyo Sang
authors.initials: HS
authors.lastname: Lee
authors.forename: Beom Seok
authors.initials: BS
authors.lastname: Ko
authors.forename: Sei Hyun
authors.initials: SH
authors.lastname: Ahn
authors.forename: Byung Ho
authors.initials: BH
authors.lastname: Son
authors.forename: Jong Won
authors.initials: JW
authors.lastname: Lee
authors.forename: Hee Jeong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Jong Han
authors.initials: JH
authors.lastname: Yu
authors.forename: Sung-Bae
authors.initials: SB
authors.lastname: Kim
authors.forename: Kyung Hae
authors.initials: KH
authors.lastname: Jung
authors.forename: Jin-Hee
authors.initials: JH
authors.lastname: Ahn
authors.forename: Joo Hee
authors.initials: JH
authors.lastname: Cha
authors.forename: Hak Hee
authors.initials: HH
authors.lastname: Kim
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Lee
authors.forename: In-Hye
authors.initials: IH
authors.lastname: Song
authors.forename: Gyungyub
authors.initials: G
authors.lastname: Gong
authors.forename: Seol-Hoon
authors.initials: SH
authors.lastname: Park
authors.forename: Jong Jin
authors.initials: JJ
authors.lastname: Lee
authors.forename: Dae Hyuk
authors.initials: DH
authors.lastname: Moon
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D018365:Neoplasm, Residual / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D013667:Technetium
chemical_list: D000970:Antineoplastic Agents; D019275:Radiopharmaceuticals; D013667:Technetium