Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan.
Department of Pathology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan.
Breast Cancer Res Treat. 2021 Jul;188(1):107-115. doi: 10.1007/s10549-021-06179-7. Epub 2021 Mar 17.
To compare the diagnostic performance of ring-type dedicated breast PET (dbPET), whole-body PET (WBPET), and DCE-MRI for predicting pathological complete response (pCR) after neoadjuvant chemotherapy (NAC).
This prospective study included 29 women with histologically proven breast cancer on needle biopsy between July 2016 and July 2019 (age: mean 55 years; range 35-78). Patients underwent WBPET followed by ring-type dbPET and DCE-MRI pre- and post-NAC for preoperative evaluation. pCR was defined as an invasive tumor that disappeared in the breast. Standardized uptake values corrected for lean body mass (SULpeak) were calculated for dbPET and WBPET scans. Maximum tumor length was measured in DCE-MRI images. Reduction rates were calculated for quantitative evaluation. Two radiologists independently evaluated the qualitative findings. Reduction rates and qualitative findings were compared between the pCR (n = 7) and non-pCR (n = 22) groups for each modality. Differences in quantitative and qualitative data between the two groups were analyzed statistically.
Significant differences were observed in the reduction rates of dbPET and DCE-MRI (P = 0.01 and 0.03, respectively) between the two groups. Univariate and multiple logistic regression analyses revealed that SULpeak reduction rates in WBPET and dbPET (P = 0.02 and P = 0.01, respectively) and in dbPET (odds ratio, 16.00; 95% CI 1.57-162.10; P = 0.01) were significant indicators associated with pCR, respectively. No between-group differences were observed in qualitative findings in the three modalities.
SULpeak reduction rate of dbPET > 82% was an independent indicator associated with pCR after NAC in breast cancer.
比较环形专用乳腺 PET（dbPET）、全身 PET（WBPET）和 DCE-MRI 对预测新辅助化疗（NAC）后病理完全缓解（pCR）的诊断性能。
本前瞻性研究纳入了 2016 年 7 月至 2019 年 7 月期间经组织学证实的乳腺浸润性癌患者 29 例（年龄：平均 55 岁；范围 35-78 岁）。患者接受了 WBPET 检查，然后在 NAC 前后进行环形 dbPET 和 DCE-MRI 检查进行术前评估。pCR 定义为乳腺内浸润性肿瘤消失。计算 dbPET 和 WBPET 扫描的体质量校正标准化摄取值（SULpeak）。在 DCE-MRI 图像中测量最大肿瘤长度。计算定量评估的减少率。两位放射科医生独立评估定性结果。对每个模态的 pCR（n=7）和非 pCR（n=22）组之间的减少率和定性结果进行比较。分析了两组之间定量和定性数据的差异。
两组间 dbPET 和 DCE-MRI 的减少率存在显著差异（P=0.01 和 0.03）。单因素和多因素逻辑回归分析显示，WBPET 和 dbPET 的 SULpeak 减少率（P=0.02 和 P=0.01）以及 dbPET 的 SULpeak 减少率（比值比，16.00；95%置信区间，1.57-162.10；P=0.01）是与 pCR 相关的显著指标。三种模态的定性结果在两组间无差异。
dbPET 的 SULpeak 减少率>82%是乳腺癌 NAC 后 pCR 的独立预测指标。
