Nariya Cho1,2,3, Seock-Ah Im4, Keon Wook Kang5,6, In-Ae Park7, In Chan Song1, Kyung-Hun Lee4, Tae-Yong Kim4, Hyunjong Lee5, In Kook Chun5,8, Hai-Jeon Yoon5,9, Woo Kyung Moon10,11,12. 1. Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea. 2. Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Republic of Korea. 3. Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea. 4. Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. 5. Department of Nuclear Medicine, Seoul National College of Medicine, Seoul, Republic of Korea. 6. Cancer Research Institute, Seoul National University, Seoul, Republic of Korea. 7. Department of Pathology, Seoul National University Hospital, Seoul, Republic of Korea. 8. Department of Nuclear Medicine, School of Medicine, Kangwon National University, Chuncheon, Gangwon-do, Republic of Korea. 9. Department of Nuclear Medicine, Ewha Woman's University, Seoul, Republic of Korea. 10. Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea. moonwk@snu.ac.kr. 11. Department of Radiology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Republic of Korea. moonwk@snu.ac.kr. 12. Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea. moonwk@snu.ac.kr.
Abstract
OBJECTIVES: 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). CONCLUSION: MRS showed comparable performance to FDG-PET in early prediction of pCR in breast cancer patients. KEY POINTS: • 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.
OBJECTIVES: 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 cancerpatients. METHODS: Thirty-five breast cancerpatients 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). CONCLUSION:MRS showed comparable performance to FDG-PET in early prediction of pCR in breast cancerpatients. KEY POINTS: • 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.
Entities:
Keywords:
Breast neoplasm; Magnetic resonance imaging; Magnetic resonance spectroscopy; Neoadjuvant chemotherapy; Positron emission tomography
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