title: Near-Infrared Diffuse Optical Imaging for Early Prediction of Breast Cancer Response to Neoadjuvant Chemotherapy: A Comparative Study Using 18F-FDG PET/CT.
abstract: Diffuse optical spectroscopic imaging (DOSI) is used as an indicator of tumor blood volume quantified by tissue hemoglobin concentrations. We aimed to determine whether early changes in tumor total hemoglobin (tHb) concentration can predict a pathologic complete response (pCR) to neoadjuvant chemotherapy in patients with operable breast cancer, and we compared the predictive value of pCR between DOSI and (18)F-FDG PET combined with CT.
  
  
  METHODS
  Of the 100 patients enrolled, 84 patients were prospectively evaluated for primary objective analysis. Sixty-four of the patients underwent both sequential DOSI scans at baseline after their first and second chemotherapy courses and (18)F-FDG PET/CT at baseline and after their second chemotherapy course. The mean tHb (tHbmean) concentration and SUVmax of the lesion were measured using DOSI and (18)F-FDG PET/CT, respectively, and the percentage change in tHbmean (∆tHbmean) and change in SUVmax (∆SUVmax) were calculated. We compared the diagnostic performances of DOSI and (18)F-FDG PET/CT for predicting pCR via the analysis of the receiver-operating-characteristic curves.
  
  
  RESULTS
  pCR was achieved in 16 patients, and neoadjuvant chemotherapy caused a significant reduction of ∆tHbmean in pCR compared with non-pCR after the 2 chemotherapy courses. When the tentative ∆tHbmean cutoff values after the first and second courses were used, the ability to predict pCR was as follows: 81.2% sensitivity/47.0% specificity and 93.7% sensitivity/47.7% specificity, respectively. Comparison of the diagnostic performances of DOSI and (18)F-FDG PET/CT revealed areas under the curve of 0.69 and 0.75 of ∆tHbmean after the first and second courses, respectively, which were lower than those of ∆SUVmax (0.90).
  
  
  CONCLUSIONS
  DOSI predicted pCR in patients with breast cancer with moderate accuracy. The diagnostic performance of DOSI was inferior to that of the early metabolic response as monitored by (18)F-FDG PET/CT.
authors.affiliation: Department of Breast Oncology, International Medical Center, Saitama Medical University, Yamane, Hidaka, Japan syueda@saitama-med.ac.jp.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Ueda
authors.affiliation: Department of Diagnostic Radiology and Nuclear Medicine, Hamamatsu University, School of Medicine, Handayama, Hamamatsu, Japan.
authors.forename: Nobuko
authors.initials: N
authors.lastname: Yoshizawa
authors.affiliation: Department of Breast Oncology, International Medical Center, Saitama Medical University, Yamane, Hidaka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Shigekawa
authors.affiliation: Department of Breast Oncology, International Medical Center, Saitama Medical University, Yamane, Hidaka, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Takeuchi
authors.affiliation: Department of Breast Surgery, Hamamatsu University, School of Medicine, Handayama, Hamamatsu, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ogura
authors.affiliation: Department of Breast Oncology, International Medical Center, Saitama Medical University, Yamane, Hidaka, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Osaki
authors.affiliation: Department of Breast Oncology, International Medical Center, Saitama Medical University, Yamane, Hidaka, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Saeki
authors.affiliation: Central Research Laboratory, Hamamatsu Photonics K.K., Hamakitaku, Hamamatsu, Japan; and.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Ueda
authors.affiliation: Department of Nuclear Medicine, International Medical Center, Saitama Medical University, Yamane, Hidaka, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Yamane
authors.affiliation: Department of Nuclear Medicine, International Medical Center, Saitama Medical University, Yamane, Hidaka, Japan.
authors.forename: Ichiei
authors.initials: I
authors.lastname: Kuji
authors.affiliation: Department of Diagnostic Radiology and Nuclear Medicine, Hamamatsu University, School of Medicine, Handayama, Hamamatsu, Japan.
authors.forename: Harumi
authors.initials: H
authors.lastname: Sakahara
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D001943:Breast Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D016903:Drug Monitoring / Q000379:methods; D055088:Early Detection of Cancer; D005260:Female; D019788:Fluorodeoxyglucose F18; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008875:Middle Aged; D057054:Molecular Imaging; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D041622:Tomography, Optical / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D006454:Hemoglobins; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: FDG-PET; breast cancer; hemoglobin; neoadjuvant chemotherapy; optical imaging