Nuclear Medicine-Radiopharmacology, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal.
NOVA Medical School, Lisbon, Portugal.
Br J Radiol. 2023 Jun 1;96(1146):20220655. doi: 10.1259/bjr.20220655. Epub 2023 Mar 3.
Complete pathological response to neoadjuvant systemic treatment (NAST) in some subtypes of breast cancer (BC) has been used as a surrogate of long-term outcome. The possibility of predicting BC pathological response to NAST based on the baseline 18F-Fluorodeoxyglucose positron emission tomography (FDG PET), without the need of an interim study, is a focus of recent discussion. This review summarises the characteristics and results of the available studies regarding the potential impact of heterogeneity features of the primary tumour burden on baseline FDG PET in predicting pathological response to NAST in BC patients. Literature search was conducted on PubMed database and relevant data from each selected study were collected. A total of 13 studies were eligible for inclusion, all of them published over the last 5 years. Eight out of 13 analysed studies indicated an association between FDG PET-based tumour uptake heterogeneity features and prediction of response to NAST. When features associated with predicting response to NAST were derived, these varied between studies. Therefore, definitive reproducible findings across series were difficult to establish. This lack of consensus may reflect the heterogeneity and low number of included series. The clinical relevance of this topic justifies further investigation about the predictive role of baseline FDG PET.
新辅助全身治疗（NAST）后某些乳腺癌（BC）亚型的完全病理缓解已被用作长期预后的替代指标。基于基线 18F-氟脱氧葡萄糖正电子发射断层扫描（FDG PET），无需进行中期研究，预测 BC 对 NAST 的病理反应的可能性是近期讨论的焦点。本综述总结了现有研究中关于肿瘤负荷基线 FDG PET 异质性特征对预测 BC 患者 NAST 病理反应的潜在影响的特征和结果。在 PubMed 数据库中进行了文献检索，并收集了每个选定研究的相关数据。共有 13 项研究符合纳入标准，均发表于过去 5 年内。13 项分析研究中有 8 项表明 FDG PET 基于肿瘤摄取异质性特征与预测 NAST 反应之间存在关联。当得出与预测 NAST 反应相关的特征时，这些特征在研究之间存在差异。因此，很难在系列中建立明确的可重复发现。这种缺乏共识可能反映了纳入系列的异质性和数量较少。该主题的临床相关性证明了进一步研究基线 FDG PET 的预测作用是合理的。
