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[18F]FDG-PET predicts complete pathological response of breast cancer to neoadjuvant chemotherapy

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Abstract

Purpose

To evaluate, in breast cancer patients treated by neoadjuvant chemotherapy, the predictive value of reduction in FDG uptake with regard to complete pathological response (pCR).

Methods

Forty-seven women with non-metastatic, non-inflammatory, large or locally advanced breast cancer were included. Tumour uptake of FDG was evaluated before and after the first course of neoadjuvant chemotherapy. Four indices were used: maximal and average SUV without or with correction by body surface area and glycaemia (SUVmax, SUVavg, SUVmax-BSA-G and SUVavg-BSA-G, respectively). The predictive value of reduction in FDG uptake with respect to pCR was studied by logistic regression analysis. Relationships between baseline [18F]FDG uptake and prognostic parameters were assessed.

Results

The relative decrease in FDG uptake (ΔSUV) after the first course of neoadjuvant chemotherapy was significantly greater in the pCR group than in the non-pCR group (p < 0.000066). The four FDG uptake indices were all strongly correlated with each other. A decrease in SUVmax-BSA-G of 85.4% ± 21.9% was found in pCR patients, versus 22.6% ± 36.6% in non-pCR patients. ΔSUVmax-BSA-G <−60% predicted the pCR with an accuracy of 87% and ΔSUVs were found to be only factors predictive of the pCR at multivariate analysis. An elevated baseline SUV was associated with high mitotic activity (p < 0.0016), tumour grading (p < 0.004), high nuclear pleomorphism score (p < 0.03) and negative hormonal receptor status (p < 0.005).

Conclusion

In breast cancer patients, after only one course of neoadjuvant chemotherapy the reduction in FDG uptake is an early and powerful predictor of pCR.

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Acknowledgements

This study is part of the PharmImage project.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Centre Georges Francois Leclerc, Dijon, France

    Alina Berriolo-Riedinger, Claude Touzery, Jean-Marc Riedinger, Michel Toubeau, Christophe Boichot, Alexandre Cochet & François Brunotte

  2. Department of Medical Oncology, Centre Georges Francois Leclerc, Dijon, France

    Bruno Coudert & Pierre Fumoleau

  3. Department of Pathology, Centre Georges Francois Leclerc, Dijon, France

    Laurent Arnould

  4. CNRS UMR 5158, Dijon, France

    François Brunotte

  5. 1rue du Professeur Marion, Dijon, 21079, France

    Alina Berriolo-Riedinger

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  1. Alina Berriolo-Riedinger
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Correspondence to Alina Berriolo-Riedinger.

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Berriolo-Riedinger, A., Touzery, C., Riedinger, JM. et al. [18F]FDG-PET predicts complete pathological response of breast cancer to neoadjuvant chemotherapy. Eur J Nucl Med Mol Imaging 34, 1915–1924 (2007). https://doi.org/10.1007/s00259-007-0459-5

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  • DOI: https://doi.org/10.1007/s00259-007-0459-5

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