Valuation of 18F-FDG PET/CT in Predicting Pathological Reaction of Neoadjuvant Chemotherapy with Breast Cancer
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摘要: 目的 评价早期应用18F-脱氧葡萄糖（FDG） PET/CT显像预测新辅助化疗疗效的价值;比较最大标准摄取值（maximum standard uptake value，SUVmax）和靶组织/非靶组织 (target organization/non-target organization，T/NT)评估新辅助化疗疗效方面的效能，选择评价疗效的合适指标及具体数值。方法前瞻性研究初治乳腺癌患者22例，在新辅助化疗前、第一疗程结束后及第二疗程结束后行18F-FDG PET-CT显像并计算其SUVmax和T/NT的变化率。结果新辅助化疗有效组在第一疗程结束后SUVmax和T/NT比值下降率与无效组比较差异有统计学意义（P值均<0.05），根据受试者工作曲线（ROC曲线）分别得到第一疗程结束后的ΔSUVmax1%最佳预测疗效值为36.3%（敏感度为83.3%，特异性为80.0%），ΔT/N1%最佳预测疗效值为42.8%（敏感度为83.3%，特异性为86.7%）;第二疗程结束后ΔSUVmax2%最佳预测疗效值为57.7%（敏感度为83.3%，特异性为93.3%），ΔT/N2%最佳预测疗效值为53.4%（敏感度为83.3%，特异性为73.3%）。结论第一疗程结束后18F-FDG PET-CT显像预测新辅助化疗疗效具有较好的可行性，支持有效者继续治疗;SUVmax在评价新辅助化疗疗效方面优于T/NT。
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关键词:
- 乳腺癌 /
- 新辅助化疗 /
- 正电子发射计算机断层显像
Abstract: Objective To evaluate the value of early application 18F- flurodeoxyglucose（FDG） PET/CT in breast cancer to neoadjuvant chemotherapy;and compare the efficiency on predicting the outcome of neoadjuvant chemotherapy between the changes of maximum standard uptake value(SUVmax) and target organization/non-target organization（T/NT），so as to select suitable index and the specific values to evaluate the therapeutic effect. Methods In a prospective trial, 18F-FDG PET-CT scans were performed in 22 women with primary breast cancer before neoadjuvant chemotherapy and after the first and second cycle of neoadjuvant chemotherapy，and the changes of SUVmax and T/NT were calculated. Results The responder group had a greater decline in SUVmax and T/NT than the non-responder group(P<0.05)at the first cycle,under the ROC curves,the best prediction effect of ΔSUVmax1% was 36.3%(sensitivity 83.3%,specificity 80.0%),the best prediction effect ofΔT/NT1% was 42.8%(sensitivity 83.3%,specificity 86.7%),the best prediction effect of ΔSUVmax2% was 57.7.3%(sensitivity 83.3%,specificity 93.3%),the best prediction effect of ΔT/NT2% was 53.4 %(sensitivity 83.3%,specificity 73.3%),respectively. Conclusion 18F-FDG PET-CT could be feasible to predict the pathological response of primary breast cancer after neoadjuvant chemotherapy at the first cycle，to support the effective patient to continue treatment,T/NT is no better than SUVmax on the neoajuvant chemotherapy efficacy evaluation in our research.-
Key words:
- Breast cancer /
- Neoadjuvant chemotherapy /
- Positron-emission tomography
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