From the *Department of Radiology, Taipei Veterans General Hospital, Taipei; †Department of Radiology, National Taiwan University College of Medicine, Taipei; ‡Department of Midwifery and Women Health Care, National Taipei University of Nursing and Health Sciences, Taipei; §Department of Medical Imaging, Taipei City Hospital, Taipei; and Departments of ∥Medical Imaging, and ¶Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Clin Nucl Med. 2017 Jul;42(7):506-513. doi: 10.1097/RLU.0000000000001684.
The aim of this study was to investigate whether integrated PET/MR system can predict the treatment response to neoadjuvant chemotherapy (NAC) early in the course of breast cancer treatment.
Fourteen women with newly diagnosed invasive breast cancer (median age, 54.5 years) were recruited. Each participant underwent 2 PET/MR studies. Study 1 was pre-NAC; study 2 was early in NAC treatment (after the first or second cycle). PET parameters included SUVmax and total lesion glycolysis (TLG). MRI parameters included choline signal-to-noise ratio (ChoSNR), peak enhancement ratio (PER), and the minimum apparent diffusion coefficient (ADCmin). The pathologic response was categorized as a pathologic complete response or residual cellularity of less than 10% (group 1) and residual cellularity of 10% or greater (group 2). The accuracy of the NAC response prediction was obtained by receiver operating characteristic analysis.
Group 1 showed a greater reduction of SUVmax (percentage change, [INCREMENT]% SUVmax, P = 0.013; area under the receiver operating characteristic curve [AUC], 0.898), TLG ([INCREMENT]%TLG, P = 0.018; AUC = 0.878), and PER ([INCREMENT]% PER, P = 0.035; AUC = 0.837) than did group 2. The ChoSNR, ADCmin, [INCREMENT]%ChoSNR, and [INCREMENT]%ADCmin did not differ significantly between the 2 groups. The hybrid markers, [INCREMENT]%SUVmax/[INCREMENT]%ADCmin (AUC = 0.976) and [INCREMENT]%TLG/[INCREMENT]%ADCmin (AUC = 0.905), showed greater accuracy in predicting NAC response than the individual PET/MR parameters.
The PET/MR parameters can predict the NAC response early in the course of breast cancer treatment. The hybrid markers more accurately predicted treatment response than the individual PET/MR parameters.
本研究旨在探讨集成 PET/MR 系统是否能够在乳腺癌治疗早期预测新辅助化疗（NAC）的治疗反应。
招募了 14 名新诊断为浸润性乳腺癌的女性（中位年龄 54.5 岁）。每位参与者接受了 2 次 PET/MR 研究。研究 1 为 NAC 前；研究 2 为 NAC 治疗早期（第一或第二周期后）。PET 参数包括 SUVmax 和总病灶糖酵解（TLG）。MRI 参数包括胆碱信号与噪声比（ChoSNR）、峰值增强比（PER）和最小表观扩散系数（ADCmin）。病理反应分为病理完全缓解或残留细胞计数<10%（组 1）和残留细胞计数≥10%（组 2）。通过受试者工作特征分析获得 NAC 反应预测的准确性。
组 1 的 SUVmax（百分比变化，[增量]%SUVmax，P=0.013；受试者工作特征曲线下面积[AUC]，0.898）、TLG（[增量]%TLG，P=0.018；AUC=0.878）和 PER（[增量]%PER，P=0.035；AUC=0.837）的降低幅度显著大于组 2。组 2 之间的 ChoSNR、ADCmin、[增量]%ChoSNR 和[增量]%ADCmin 无显著差异。混合标志物[增量]%SUVmax/[增量]%ADCmin（AUC=0.976）和[增量]%TLG/[增量]%ADCmin（AUC=0.905）在预测 NAC 反应方面比单个 PET/MR 参数具有更高的准确性。
PET/MR 参数可以在乳腺癌治疗早期预测 NAC 反应。混合标志物比单个 PET/MR 参数更能准确预测治疗反应。
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