Park Jeong Seon, Moon Woo Kyung, Lyou Chae Yeon, Cho Nariya, Kang Keon Wook, Chung June-Key
Department of Radiology, College of Medicine Seoul National University and the Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea.
Acta Radiol. 2011 Feb 1;52(1):21-8. doi: 10.1258/ar.2010.100142.
Neoadjuvant chemotherapy for locally advanced breast cancer is a widely accepted treatment. For assessment of the tumor response after chemotherapy, both magnetic resonance imaging (MRI) and (18)F-fluorodeoxyglucose positron emission tomography (PET) are promising methods.
To retrospectively compare MRI and PET in the assessment of tumor response to neoadjuvant chemotherapy for primary breast cancer with the pathologic response as the reference standard.
Between August 2006 and May 2008, 32 women with breast cancer underwent concurrent MRI and PET before and after neoadjuvant chemotherapy. For response assessment, we calculated the changes in the maximum diameters of the tumor (ΔD(max)) on MRI, and the changes in the standard uptake values (ΔSUV) on PET. The correlation between the ΔD(max) and ΔSUV was analyzed using Pearson's correlation coefficient. The correspondence rates between each imaging modality and pathologic assessment were calculated. For prediction of the pathologic complete response (pCR), the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were analyzed using the McNemar test.
The pathologic assessment of tumor response to neoadjuvant chemotherapy identified eight complete responses (25.0%), 10 partial responses (31.2%), and 14 non-responses (43.8%). The change in size on MRI was moderately correlated with the change in SUV on PET (r=0.574, p=0.001). The correspondence rate of response assessment was 75.0% (24/32) between MRI and pathologic response and 53.1% (17/32) between PET and pathologic response. For the pCR, specificity (95.8% vs. 62.5%) and PPV (83.3% vs. 47.1%) were statistically higher on MRI than PET (p < 0.05), while sensitivity (100.0% vs. 62.5%) and NPV (100.0% vs. 88.5%) on PET tended to be higher than MRI.
Before and after neoadjuvant chemotherapy for breast cancer, the ΔD(max) of MRI correlated moderately with the ΔSUV on PET. For prediction of the pCR, MRI proved to be a more specific modality than PET.
新辅助化疗用于局部晚期乳腺癌是一种被广泛接受的治疗方法。对于评估化疗后的肿瘤反应，磁共振成像（MRI）和氟脱氧葡萄糖正电子发射断层扫描（PET）都是很有前景的方法。
以病理反应为参考标准，回顾性比较MRI和PET在评估原发性乳腺癌新辅助化疗后肿瘤反应中的应用。
2006年8月至2008年5月期间，32例乳腺癌女性患者在新辅助化疗前后同时接受了MRI和PET检查。为了评估反应，我们计算了MRI上肿瘤最大直径的变化（ΔD(max)）以及PET上标准摄取值的变化（ΔSUV）。使用Pearson相关系数分析ΔD(max)与ΔSUV之间的相关性。计算每种成像方式与病理评估之间的符合率。对于病理完全缓解（pCR）的预测，使用McNemar检验分析敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。
对新辅助化疗的肿瘤反应进行病理评估，发现8例完全缓解（25.0%），10例部分缓解（31.2%），14例无反应（43.8%）。MRI上的大小变化与PET上的SUV变化呈中度相关（r = 0.574，p = 0.001）。MRI与病理反应之间的反应评估符合率为75.0%（24/32），PET与病理反应之间的符合率为53.1%（17/32）。对于pCR，MRI的特异性（95.8%对62.5%）和PPV（83.3%对47.1%）在统计学上高于PET（p < 0.05），而PET的敏感性（100.0%对62.5%）和NPV（100.0%对88.5%）倾向于高于MRI。
乳腺癌新辅助化疗前后，MRI的ΔD(max)与PET上的ΔSUV呈中度相关。对于pCR的预测，MRI被证明是比PET更具特异性的检查方式。
