18F-FDG PET/CT早期预测乳腺癌新辅助化疗病理完全缓解的价值

doi:DOI:10.12117/jccmi.2019.05.003

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Abstract Objective: To discuss whether early change in maximum standard uptake value(SUVmax) of 18F-flurodeoxy glucose using positron emission tomography with computed tomography(18F-FDG PET/CT) can predict pathologic complete response(pCR) of primary breast to neoadjuvant chemotherapy(NAC). Methods: 61 women with primary breast cancer underwent 18F-FDG PET/CT scanning at baseline, after the first and second course of NAC. The changes of SUVmax were calulated(ΔSUVmax1% and ΔSUVmax2%). Surgery was performed for all patients for pCR evaluation. Receiver operating characteristic(ROC) curves were used to assess the pCR predicting ability of ΔSUVmax1% and ΔSUVmax2%. Results: The pCR group had a greater decline in SUVmax than the non-pCR group(all P=0.001) after the first and second course of NAC. Under the ROC curves, the best prediction effect of ΔSUVmax1% was 40.5%(sensitivity 85.7%, specificity 67.7%), the best prediction effect of ΔSUVmax2% was 56.5%(sensitivity 84.6%, specificity 57.1%), respectively. The respective area under the ROC curves(AUC) for ΔSUVmax1% and ΔSUVmax2% in the prediction of pCR were 0.867 and 0.820(P=0.003,0.001), but the differences of AUCs between ΔSUVmax1% and ΔSUVmax2% were not significant in predicting pCR. ΔSUVmax1% and ΔSUVmax2% were significantly useful for differentiating pCR from non-pCR in Luminal subtype(P=0.041, 0.005). For non-Luminal subtype, ΔSUVmax1% of pCR group was significantly different from that in non-pCR group(P=0.012), but ΔSUVmax2% was not significantly different between the two groups(P=0.100). Conclusion: Early changes in SUVmax of 18F-FDG PET/CT scanning after first or second cycles of NAC could predict pCR in breast cancer effectively and guide clinical individualized treatment. Only ΔSUVmax1% was efficiently predictive of pCR in non-Luminal subtype.

Key words： Breast neoplasms Tomography, spiral computed Positron-emission tomography

Received: 14 October 2018

PACS:	Ｒ737.9
	Ｒ817.4
	Ｒ814.42

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	Articles by authors
	LU Sheng-nan
	FENG Yan-lin
	LI Wen
	WANG Ying
	XIAN Wei-jun
	YANG Ming

Cite this article:

LU Sheng-nan,FENG Yan-lin,LI Wen, et al. Early prediction value of 18F-FDG PET/CT for pathological complete reaction in breast cancer patients following neoadjuvant chemotherapy[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2019, 30(5): 313-317.

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http://www.jccmi.com.cn/EN/DOI:10.12117/jccmi.2019.05.003 OR http://www.jccmi.com.cn/EN/Y2019/V30/I5/313

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