Diagnostic performance of fluorodeoxyglucose-positron emission tomography/computed tomography combined with ultrasonography-guided fine needle aspiration cytology for identifying axillary lymph node status in patients with breast cancer

Machida, Youichi; Kubota, Kazunori; Katayama, Takashi; Toriihara, Akira; Shibuya, Hitoshi

doi:10.1016/j.ejso.2012.10.012

Cited by 18 publications

(18 citation statements)

References 14 publications

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“…However, treatment options and responses to therapy differ greatly among various phenotypes. These differences complicate the utilization of ΔSUV as a predictor of pathological responses [ 8 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

18F-fluorodeoxyglucose (FDG) PET/CT after two cycles of neoadjuvant therapy may predict response in HER2-negative, but not in HER2-positive breast cancer

Cheng

Wang

et al. 2015

Oncotarget

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The aim of this prospective study was to assess the ability of 18F-fluorodeoxyglucose (18FDG) positron emission tomography/computed tomography (PET/CT) scanning to predict pathological complete response (pCR) in breast cancer, and to investigate whether timing of the scan and trastuzumab treatment influence the accuracy of pCR prediction in human epidermal growth factor receptor 2 (HER2) positive breast cancer patients. We treated 81 locally advanced breast cancer patients with four cycles of neoadjuvant chemotherapy (NAC). HER2-negative breast cancer patients received NAC alone, while HER2-positive breast cancer patients received NAC plus trastuzumab. 18FDG PET/CT scans were scheduled at baseline and after the second cycle of NAC. Axillary lymph node (ALN) dissection was performed after the last cycle of neoadjuvant therapy. Relative changes in standardized uptake values (SUV) between the two PET/CT scans (ΔSUV) in primary tumors and ALN metastases were calculated. There were 75 patients with 150 PET/CT scans in the final analysis, including 41 HER2-negative and 34 HER2-positive cases. In the HER2-negative group, the ΔSUV predicted overall and ALN pCR; the receiver operating characteristics-areas under curve (ROC-AUC) were 0.87 and 0.80 (P = 0.0014 and 0.031, respectively) and the negative predictive values were 94% and 89% respectively. However, in the HER2-positive group, ΔSUV could predict neither overall nor ALN pCR; the ROC-AUCs were only 0.56 and 0.53, with P = 0.53 and 0.84, respectively. Hence, the ΔSUV after two cycles of neoadjuvant therapy could predict pCR in HER2-negative patients treated with NAC alone, but not in HER2-positive patients treated with NAC plus trastuzumab.

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Section: Introductionmentioning

confidence: 99%

18F-fluorodeoxyglucose (FDG) PET/CT after two cycles of neoadjuvant therapy may predict response in HER2-negative, but not in HER2-positive breast cancer

Cheng

Wang

et al. 2015

Oncotarget

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“…9,34,[39][40][41][45][46][47] Positron emission tomography-CT is another method that can be used for preoperative ALN staging; however, it was reported to have a lower spatial resolution and a wide range of false-positive rates (0%-15.3%). 11,[15][16][17]29,[48][49][50] Therefore, in this study, we intended to compare the diag- nostic performance of 3 modalities: sonography, sonographically guided FNA, and FDG PET-CT. Although these modalities are commonly used as preoperative evaluation methods, reports on their performance are highly variable.…”

Section: Discussionmentioning

confidence: 99%

Role of [¹⁸F]Fluorodeoxyglucose Positron Emission Tomography—Computed Tomography, Sonography, and Sonographically Guided Fine–Needle Aspiration Biopsy in the Diagnosis of Axillary Lymph Nodes in Patients With Breast Cancer

Sohn

Hong

Han

2014

J of Ultrasound Medicine

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“…After fasting for at least 4 h, the patients received an intravenous injection of 18F-FDG (3.7 MBq/kg). Visual assessment of 18F-FDG uptake was determined by consensus by two radiologists (Machida et al 2013 ).…”

Section: Methodsmentioning

confidence: 99%

Efficiency of fluorodeoxyglucose positron emission tomography/computed tomography to predict prognosis in breast cancer patients received neoadjuvant chemotherapy

et al. 2015

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Neoadjuvant chemotherapy (NAC) has become a standard therapy for patients with advanced breast cancer. Pathological complete response (pCR) after NAC is an important prognostic indicator, but some patients with pCR continue to experience recurrence. So new predictive and prognostic markers in addition to pCR are needed following NAC for breast cancer. Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) can evaluate metastases in the entire body simultaneously, and has several potential advantages over conventional imaging modalities. The purpose of this study was to evaluate whether FDG-PET/CT can determine NAC response and whether FDG-PET/CT can be a new prognostic marker. We imaged 83 breast cancer tumors with FDG-PET/CT, ultrasound (US), and magnetic resonance imaging (MRI) to evaluate NAC efficacy. As we previously analyzed 110 breast cancers with FDG PET/CT, we defined a threshold of >1.7 maximum standardized uptake value (SUVmax) as abnormal fluorodeoxyglucose (FDG) uptake. After NAC, 16 (19.3 %) tumors had a complete response, 54 (65.1 %) had a partial response, 11 (13.3 %) showed stable disease, and 2 (2.4 %) showed progressive disease. One of the two patients with progressive disease had bone metastasis detected by FDG-PET/CT and was not operated on. Remote metastases were evident in 2.4 % of patients after NAC as determined by FDG-PET/CT. Overall, 17 patients had pathological complete response (pCR). The sensitivity of abnormal FDG uptake after NAC for non-pCR was 20.3 % and the specificity was 94.7 %. Patients with abnormal FDG uptake after NAC experienced significantly more recurrences (P = 0.004) and more of them died (P = 0.010). Moreover, the difference in disease-free survival was more significant in the estrogen receptor (ER)-negative group. FDG-PET after NAC may be more effective for predicting prognosis than for evaluating treatment response. This tendency was particularly remarkable in ER-negative breast cancer tumors. FDG-PET/CT is useful for reevaluating surgical applicability after NAC.

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Diagnostic performance of fluorodeoxyglucose-positron emission tomography/computed tomography combined with ultrasonography-guided fine needle aspiration cytology for identifying axillary lymph node status in patients with breast cancer

Cited by 18 publications

References 14 publications

18F-fluorodeoxyglucose (FDG) PET/CT after two cycles of neoadjuvant therapy may predict response in HER2-negative, but not in HER2-positive breast cancer

18F-fluorodeoxyglucose (FDG) PET/CT after two cycles of neoadjuvant therapy may predict response in HER2-negative, but not in HER2-positive breast cancer

Role of [¹⁸F]Fluorodeoxyglucose Positron Emission Tomography—Computed Tomography, Sonography, and Sonographically Guided Fine–Needle Aspiration Biopsy in the Diagnosis of Axillary Lymph Nodes in Patients With Breast Cancer

Efficiency of fluorodeoxyglucose positron emission tomography/computed tomography to predict prognosis in breast cancer patients received neoadjuvant chemotherapy

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Diagnostic performance of fluorodeoxyglucose-positron emission tomography/computed tomography combined with ultrasonography-guided fine needle aspiration cytology for identifying axillary lymph node status in patients with breast cancer

Cited by 18 publications

References 14 publications

18F-fluorodeoxyglucose (FDG) PET/CT after two cycles of neoadjuvant therapy may predict response in HER2-negative, but not in HER2-positive breast cancer

18F-fluorodeoxyglucose (FDG) PET/CT after two cycles of neoadjuvant therapy may predict response in HER2-negative, but not in HER2-positive breast cancer

Role of [18F]Fluorodeoxyglucose Positron Emission Tomography—Computed Tomography, Sonography, and Sonographically Guided Fine–Needle Aspiration Biopsy in the Diagnosis of Axillary Lymph Nodes in Patients With Breast Cancer

Efficiency of fluorodeoxyglucose positron emission tomography/computed tomography to predict prognosis in breast cancer patients received neoadjuvant chemotherapy

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Role of [¹⁸F]Fluorodeoxyglucose Positron Emission Tomography—Computed Tomography, Sonography, and Sonographically Guided Fine–Needle Aspiration Biopsy in the Diagnosis of Axillary Lymph Nodes in Patients With Breast Cancer