Sequential Positron Emission Tomography Using [18F]Fluorodeoxyglucose for Monitoring Response to Chemotherapy in Metastatic Breast Cancer

Abstract

Purpose: To evaluate the clinical value of positron emission tomography (PET) for monitoring chemotherapy in metastatic breast cancer. Experimental Design: Twenty patients with hormonorefractory or hormonoreceptor-negative multimetastatic breast cancer were prospectively included. PET studies were done at baseline, at day 21 after the first cycle and at day 21 after the third cycle of chemotherapy. Metabolic response was defined based on visual and various modes of standardized uptake value (SUV) analysis of sequential PETstudies. Results: After one cycle, PET indicated a partial response in 12 patients, stable disease in 7 patients, and progressive disease in 1patient, according to the visual analysis. After three cycles, PET showed a complete response in 5 patients, partial response in 11 patients, stable disease in 3 patients, and progressive disease in 1 patient. Seventy-five percent of the patients showing a metabolic response on visual analysis effectively responded to the treatment. The average SUV decreased on both the second and the third PET study, but only changes measured after three cycles of chemotherapy predicted the clinical response to chemotherapy and the overall survival. All methods for calculating the SUV (normalized for body weight, body surface area, or lean body mass) provided similar results. Conclusion: Semiquantitative analysis of [ 18 F]fluorodeoxyglucose-PETstudies done after three cycles of chemotherapy is useful for monitoring the response to chemotherapy in metastatic breast cancer.

The Role of Radiotracer Imaging in the Diagnosis and Management of Patients with Breast Cancer: Part 2—Response to Therapy, Other Indications, and Future Directions

“…Some studies suggested that imaging as early as after 1 cycle of chemotherapy could predict response (69), akin to the neoadjuvant therapy setting. However, other studies have not shown similar accuracy for early repeated 18 F-FDG PET (67). The level of 18 F-FDG uptake after therapy has also been shown to be predictive.…”

“…Several relatively small studies have been conducted evaluating serial 18 F-FDG PET for measuring MBC response to treatment. Most studies showed, similar to neoadjuvant therapy, that response is accompanied by substantial drops in 18 F-FDG uptake, typically 40%250% or more from the pretherapy baselines (67)(68)(69). Some studies suggested that imaging as early as after 1 cycle of chemotherapy could predict response (69), akin to the neoadjuvant therapy setting.…”

Cancer du sein métastatique

“…On pourrait ainsi modifier rapidement le traitement instauré en cas d'é volution dé favorable. Plusieurs articles ont é té publié s à ce sujet [60,74]. Il serait utile de disposer d'un examen PET-scan pré traitement.…”

The Relationship Between Estrogen Receptor, Progesterone Receptor and Human Epidermal Growth Factor Receptor 2 Expression of Breast Cancer and the Retention Index in Dual Phase 18F-FDG PET/CT

“…18 F-fluorodeoxyglucose positron emission tomographycomputed tomography (FDG PET/CT) has been important in the management of breast cancer patients [6]. It is used for screening for the extra-axillary lymph node metastasis [7] and distant metastasis [8,9], assessing for the treatment responses [10,11], and predicting prognosis [12], but the benefit of FDG PET/CT scanning for staging remains a matter of debate [13]. Several studies have suggested that the characteristics of FDG uptake in breast cancer are relevant to biological or histological attributes of primary tumor, including its biomarker status [14][15][16][17][18][19].…”