metricas
covid
Buscar en
Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)
Toda la web
Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Predictive value of PET-CT for pathological response in stages II and III breast...
Journal Information
Vol. 33. Issue 1.
Pages 14-21 (January - February 2014)
Share
Share
Download PDF
More article options
Visits
711
Vol. 33. Issue 1.
Pages 14-21 (January - February 2014)
Original article
Predictive value of PET-CT for pathological response in stages II and III breast cancer patients following neoadjuvant chemotherapy with docetaxel
Valor predictivo de la PET-TC en la respuesta a la quimioterapia neoadyuvante en el cáncer de mama en estadios II y III
Visits
711
Marta A. García García-Esquinasa,b,
Corresponding author
marta.garcia@gmx.de

Corresponding author at: Servicio de Radiodiagnóstico, Hospital Clínico San Carlos, C/Cardenal Cisneros 41013, Madrid, Spain.
, Juan Arrazola Garcíab, José A. García-Sáenzc, V. Furió-Baceted, Manuel E. Fuentes Ferrere, Aída Ortega Candila, María N. Cabrera Martína, José L. Carreras Delgadoa
a Nuclear Medicine Department, Hospital Clínico San Carlos, Madrid, Spain
b Radiology Department, Hospital Clínico San Carlos, Madrid, Spain
c Medical Oncology Department, Hospital Clínico San Carlos, Madrid, Spain
d Pathology Department, Hospital Clínico San Carlos, Madrid, Spain
e Research Support Unit, Hospital Clínico San Carlos, Madrid, Spain
This item has received
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (7)
Show moreShow less
Tables (4)
Table 1. Patient and tumor characteristics.
Table 2. Diagnostic accuracy of ΔSUVmax to predict tumor, lymph node and locoregional pCR.
Table 3. Baseline SUV and ΔSUV in locoregional disease.
Table 4. Diagnostic accuracy of Δ SUVmax to differentiate RCB-0 and RCB-I classes from II and III.
Show moreShow less
Abstract
Purpose

To prospectively study the value of PET-CT with fluorine-18 fluorodeoxyglucose (FDG) to predict neoadjuvant chemotherapy (NAC) response of locoregional disease of stages II and III breast cancer patients.

Material and methods

A written informed consent and approval were obtained from the Ethics Committee. PET-CT accuracy in the prediction of pathologic complete response (pCR) after NAC was studied in primary tumors and lymph node metastasis in 43 women (mean age: 50 years: range: 27–71 years) with histologically proven breast cancer between December 2009 and January 2011. PET-CT was performed at baseline and after NAC. SUVmax percentage changes (ΔSUVmax) were compared with pathology findings at surgery. Receiver-operator characteristic (ROC) analysis was used to discriminate between locoregional pCR and non-pCR. In patients not achieving pCR, it was investigated if ΔSUVmax could accurately identify the residual cancer burden (RCB) classes: RCB-I (minimal residual disease (MRD)), RCB-II (moderate RD), and RCB-III (extensive RD).

Results

pCR was obtained in 11 patients (25.6%). Residual disease was found in 32 patients (74.4%): 16 (37.2%) RCB-I, 15 (35.6%) RCB-II and 2 (4.7%) RCB-III. Sensitivity, specificity, and accuracy to predict pCR were 90.9%, 90.6%, and 90.7%, respectively. Specificity was 94.1% in the identification of a subset of patients who had either pCR or MRD.

Conclusion

Accuracy of ΔSUVmax in the locoregional disease of stages II and III breast cancer patients after NAC is high for the identification of pCR cases. Its specificity is potentially sufficient to identify a subgroup of patients who could be managed with conservative surgery.

Keywords:
Breast cancer
Neoadjuvant chemotherapy
PET-CT
Resumen
Objetivo

Estudiar de forma prospectiva el valor de la PET-TC con fluor-18-desoxiglucosa (FDG) para predecir la respuesta a la quimioterapia neoadyuvante (NAC) de la enfermedad locoregional en pacientes con cáncer de mama en estadios II y III.

Material y métodos

Se obtuvo un consentimiento informado por escrito y la aprobación del Comité Ético. Se estudió la precisión de la PET-TC para predecir la respuesta completa patológica (pCR) tras la NAC en los tumores y en los ganglios de 43 mujeres (edad media: 50 años; rango: 27–71 años) que presentaban cáncer de mama diagnosticado por histología entre diciembre del 2009 y Enero del 2011. Los estudios PET-TC se realizaron al diagnóstico y tras la NAC. Los cambios en el porcentaje del SUVmax (delta-SUVmax) se compararon con los hallazgos de la anatomía patológica de la pieza quirúrgica. Se realizaron análisis de Característica Operativa del Receptor (ROC) para discriminar entre pCR y no-pCR en la enfermedad locoregional. En las pacientes que no alcanzaron la pCR, se investigó si el delta-SUVmax podía identificar de forma precisa las siguientes categorías de carga tumoral residual: RCB-I (enfermedad mínima residual (MRD)), RCB-II (moderada RD), y RCB-III (extensa RD).

Resultados

Se obtuvo pCR en 11 pacientes (25,6%). Se encontró enfermedad residual en 32 pacientes (74,4%): 16 (37,2%) RCB-I, 15 (35,6%) RCB-II y 2 (4,7%) RCB-III. La sensibilidad, especificidad y precisión para predecir la pCR fueron 90,9%, 90,6%, y 90,7%, respectivamente. En la identificación del subgrupo de pacientes con pCR o MRD la especificidad fue del 94,1%.

Conclusión

El delta-SUVmax identifica con elevada precisión la pCR en la enfermedad locoregional de las pacientes con cáncer de mama en estadios II y III tras la NAC. La especificidad es potencialmente suficiente para identificar un subgrupo de pacientes que podrían ser candidatas a cirugía conservadora.

Palabras clave:
Cáncer de mama
Quimioterapia neoadyuvante
PET-TC

Article

These are the options to access the full texts of the publication Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Revista Española de Medicina Nuclear e Imagen Molecular (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos