title: Evaluation of the Response to Breast Cancer Neoadjuvant Chemotherapy Using 18F-FDG Positron Emission Mammography Compared With Whole-Body 18F-FDG PET: A Prospective Observational Study.
abstract: OBJECTIVE
  The aim of this study was to assess therapeutic response to breast cancer neoadjuvant chemotherapy (NAC) by F-FDG positron emission mammography (PEM) compared with that to whole-body F-FDG PET (WBPET).
  
  
  METHODS
  Twenty patients underwent WBPET and PEM 3 times: the first time was before NAC, the second time was after 2 courses of NAC, and the third time was after all courses of NAC. A pathological complete response (pCR) was defined as no evidence of residual invasive cancer with or without ductal carcinoma in situ. The relationships between each modality's SUVmax and pathological response were evaluated.
  
  
  RESULTS
  Nine patients achieved a pCR, whereas the other 11 patients had a non-pCR. The SUVmax of WBPET after 2 courses of NAC was significantly lower in the pCR group than in the non-pCR group (1.4 ± 0.4 vs 2.7 ± 2.1, P = 0.0334). There were no significant differences in the SUVmax of PEM (ie, PEM uptake value [PUV]) between the groups. The SUVmax of WBPET (area under the ROC curve [AUC] = 0.761) was superior to the PUVmax (AUC, 0.648) for predicting non-pCR at the interim time point. After all courses of chemotherapy, there were no significant differences between the groups in the SUVmax of WBPET; however, PUVmax was significantly lower in the pCR group than in the non-pCR group (1.0 ± 0.2 vs 2.5 ± 2.7, P = 0.0351). After NAC, the PUVmax (AUC, 0.796) was superior to the SUVmax of WBPET (AUC, 0.671).
  
  
  CONCLUSIONS
  There proved to be no apparent superiority of PEM in predicting pCR at the interim time point. Positron emission mammography had greater diagnostic capability for detecting residual cancer after all courses of NAC.
authors.affiliation: From the *Department of Radiology, Graduate School of Medicine, Yokohama City University, Yokohama; †Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama; Departments of ‡Gastroenterological Surgery, and §Biostatics and Epidemiology, Yokohama City University Graduate School of Medicine, Yokohama; and ∥Department of Breast Surgery, Tokyo Medical University, Tokyo, Japan.
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Noritake
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Narui
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kaneta
authors.forename: Sadatoshi
authors.initials: S
authors.lastname: Sugae
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sakamaki
authors.forename: Tomio
authors.initials: T
authors.lastname: Inoue
authors.forename: Takashi
authors.initials: T
authors.lastname: Ishikawa
mesh_terms: D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D019540:Area Under Curve; D001940:Breast / Q000000981:diagnostic imaging*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D016190:Carboplatin / Q000008:administration & dosage; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000188:drug therapy; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging* / Q000188:drug therapy; D018276:Carcinoma, Medullary / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D043823:Taxoids / Q000008:administration & dosage; D000068878:Trastuzumab / Q000008:administration & dosage; D016896:Treatment Outcome; D051598:Whole Body Imaging
chemical_list: D018943:Anthracyclines; D019275:Radiopharmaceuticals; D043823:Taxoids; D019788:Fluorodeoxyglucose F18; D016190:Carboplatin; D000068878:Trastuzumab