Assessment of tumor response to chemotherapy in patients with breast cancer using (18)F-FLT: a meta-analysis.
OBJECTIVE
To determine the diagnostic performance of 3'-deoxy-3'-(18)F-fluorothymidine positron emission tomography/computed tomography (FLT PET/CT) and FLT PET for evaluating response to chemotherapy in patients with breast cancer.


METHODS
Databases such as PubMed (MEDLINE included) and excerpta medica database (EMBASE), were searched for relevant original articles. The included studies were assessed for methodological quality with quality assessment of diagnosis accuracy studies (QUADAS) score tool. Histopathological analysis and/or clinical and/or radiological follow-up for at least 6 months were used as the reference standard. The data were extracted by two reviewers independently to analyze the sensitivity, specificity, summary receiver operating characteristic (SROC) curve, area under the curve (AUC), and heterogeneity.


RESULTS
The present study analyzed a total of 4 selected articles. The pool sensitivity was 0.773 [95% confidence interval (CI): 0.594-0.900]. The pooled specificity was 0.685 (95% CI: 0.479-0.849) on basis of FEM. The pooled LR+, LR-, and DOR were 2.874 (1.492-5.538), 0.293 (0.146-0.589), and 14.891 (3.238-68.475), respectively. The AUC was 0.8636 (±0.0655), and the Q* index was 0.7942 (±0.0636).


CONCLUSIONS
Our results indicate that (18)F-FLT PET/CT or PET is useful to predict chemotherapy response in breast cancer with reasonable sensitivity, specificity and DOR. However, future larger scale clinical trials will be needed to assess the regimen of (18)F-FLT PET/CT or PET in monitoring the response to chemotherapy in breast cancer patients.
1 Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou 215000, China ; 2 School of Radiation Medicine and Protection, Medical College of Soochow University, Suzhou 215000, China ; 3 Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi 214000, China.
Sheng-Ming
SM
Deng
1 Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou 215000, China ; 2 School of Radiation Medicine and Protection, Medical College of Soochow University, Suzhou 215000, China ; 3 Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi 214000, China.
Wei
W
Zhang
1 Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou 215000, China ; 2 School of Radiation Medicine and Protection, Medical College of Soochow University, Suzhou 215000, China ; 3 Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi 214000, China.
Bin
B
Zhang
1 Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou 215000, China ; 2 School of Radiation Medicine and Protection, Medical College of Soochow University, Suzhou 215000, China ; 3 Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi 214000, China.
Yi-Wei
YW
Wu
18F-FLT PET; Breast cancer; chemotherapy; meta-analysis