title: Early prediction of response to neoadjuvant chemotherapy in breast cancer patients: comparison of single-voxel (1)H-magnetic resonance spectroscopy and (18)F-fluorodeoxyglucose positron emission tomography.
abstract: OBJECTIVE
  To prospectively compare performances of single-voxel proton magnetic resonance spectroscopy ((1)H-MRS) and (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) in predicting pathologic response to neoadjuvant chemotherapy (NAC) in breast cancer patients.
  
  
  METHODS
  Thirty-five breast cancer patients who received NAC and subsequent surgery were prospectively enrolled. MRS and FDG-PET were performed before and after the 1st NAC cycle. Percentage changes of total choline-containing compounds (tCho) via MRS, and maximum and peak standardized uptake values (SUVmax, SUVpeak) and total lesion glycolysis (TLG) via FDG-PET were measured, and their performances in predicting pathologic complete response (pCR) were compared.
  
  
  RESULTS
  Of the 35 patients, 6 showed pCR and 29 showed non-pCR. Mean % reductions of tCho, SUVmax, SUVpeak, and TLG of the pCR group were larger than those of the non-pCR group (-80.3 ± 13.9 % vs. -32.1 ± 49.4 %, P = 0.025; -54.7 ± 22.1 % vs. -26.3 ± 33.7 %, P = 0.058; -60.7 ± 18.3 % vs. -32.3 ± 23.3 %, P = 0.009; -89.5 ± 8.5 % vs. -52.6 ± 36.2 %, P = 0.020). Diagnostic accuracy (area under ROC curve; Az, 0.911) of the % reduction of tCho was comparable to those of %SUVmax (0.822), SUVpeak (0.862), and TLG (0.879) in distinguishing pCR from non-pCR (all P > 0.05).
  
  
  CONCLUSIONS
  MRS showed comparable performance to FDG-PET in early prediction of pCR in breast cancer patients.
  
  
  CONCLUSIONS
  • MRS can predict response to NAC in breast cancer post-1 (st) cycle. • Changes in tCho and SUV after NAC reflect tumour cellularity changes. • MRS can be an alternative to FDG-PET in predicting response to NAC.
authors.affiliation: Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea.|Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Republic of Korea.|Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
authors.forename: Nariya
authors.initials: N
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Seock-Ah
authors.initials: SA
authors.lastname: Im
authors.affiliation: Department of Nuclear Medicine, Seoul National College of Medicine, Seoul, Republic of Korea.|Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.
authors.forename: Keon Wook
authors.initials: KW
authors.lastname: Kang
authors.affiliation: Department of Pathology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: In-Ae
authors.initials: IA
authors.lastname: Park
authors.affiliation: Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea.
authors.forename: In Chan
authors.initials: IC
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Kyung-Hun
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Tae-Yong
authors.initials: TY
authors.lastname: Kim
authors.affiliation: Department of Nuclear Medicine, Seoul National College of Medicine, Seoul, Republic of Korea.
authors.forename: Hyunjong
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Nuclear Medicine, Seoul National College of Medicine, Seoul, Republic of Korea.|Department of Nuclear Medicine, School of Medicine, Kangwon National University, Chuncheon, Gangwon-do, Republic of Korea.
authors.forename: In Kook
authors.initials: IK
authors.lastname: Chun
authors.affiliation: Department of Nuclear Medicine, Seoul National College of Medicine, Seoul, Republic of Korea.|Department of Nuclear Medicine, Ewha Woman's University, Seoul, Republic of Korea.
authors.forename: Hai-Jeon
authors.initials: HJ
authors.lastname: Yoon
authors.affiliation: Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea. moonwk@snu.ac.kr.|Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Republic of Korea. moonwk@snu.ac.kr.|Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea. moonwk@snu.ac.kr.
authors.forename: Woo Kyung
authors.initials: WK
authors.lastname: Moon
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D019275:Radiopharmaceuticals; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Breast neoplasm; Magnetic resonance imaging; Magnetic resonance spectroscopy; Neoadjuvant chemotherapy; Positron emission tomography