Department of Nuclear Medicine, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, 31151, Republic of Korea.
Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea.
Cancer Imaging. 2024 Oct 11;24(1):136. doi: 10.1186/s40644-024-00787-4.
Since it has been found that the maximum metabolic activity of a cancer lesion shifts toward the lesion edge during cancer progression, normalized distances from the hot spot of radiotracer uptake to tumor centroid (NHOC) and tumor perimeter (NHOP) have been suggested as novel F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) parameters that can reflect cancer aggressiveness. This study aimed to investigate whether NHOC and NHOP parameters could predict pathological response to neoadjuvant chemotherapy (NAC) and progression-free survival (PFS) in breast cancer patients.
This study retrospectively enrolled 135 female patients with breast cancer who underwent pretreatment FDG PET/CT and received NAC and subsequent surgical resection. From PET/CT images, normalized distances of maximum SUV and peak SUV-to-tumor centroid (NHOCmax and NHOCpeak) and -to-tumor perimeter (NHOPmax and NHOPpeak) were measured, in addition to conventional PET/CT parameters.
Of 135 patients, 32 (23.7%) achieved pathological complete response (pCR), and 34 (25.2%) had events during follow-up. In the receiver operating characteristic (ROC) curve analysis, NHOCmax showed the highest area under the ROC curve value (0.710) for predicting pCR, followed by NHOCpeak (0.694). In the multivariate logistic regression analysis, NHOCmax, NHOCpeak, and NHOPmax were independent predictors for pCR (p < 0.05). In the multivariate survival analysis, NHOCpeak (p = 0.026) was an independent predictor for PFS along with metabolic tumor volume, with patients having higher NHOCpeak showing worse PFS.
NHOCpeak on pretreatment FDG PET/CT could be a potential imaging parameter for predicting NAC response and survival in patients with breast cancer.
由于已经发现癌症病灶的最大代谢活性在癌症进展过程中向病灶边缘转移，因此已提出标准化放射性示踪剂摄取热点到肿瘤质心（NHOC）和肿瘤周长（NHOP）的距离作为反映癌症侵袭性的新型 F-18 氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）参数。本研究旨在探讨 NHOC 和 NHOP 参数是否可以预测乳腺癌患者新辅助化疗（NAC）的病理反应和无进展生存期（PFS）。
本研究回顾性纳入了 135 名接受 FDG PET/CT 预处理并接受 NAC 及后续手术切除的女性乳腺癌患者。从 PET/CT 图像中测量了最大 SUV 和峰值 SUV 到肿瘤质心（NHOCmax 和 NHOCpeak）和到肿瘤周长（NHOPmax 和 NHOPpeak）的标准化距离，以及常规 PET/CT 参数。
在 135 名患者中，32 名（23.7%）达到病理完全缓解（pCR），34 名（25.2%）在随访期间出现事件。在受试者工作特征（ROC）曲线分析中，NHOCmax 对预测 pCR 的 ROC 曲线下面积值最高（0.710），其次是 NHOCpeak（0.694）。在多变量逻辑回归分析中，NHOCmax、NHOCpeak 和 NHOPmax 是 pCR 的独立预测因素（p < 0.05）。在多变量生存分析中，NHOCpeak（p = 0.026）是 PFS 的独立预测因素，与代谢肿瘤体积一起，NHOCpeak 较高的患者 PFS 较差。
FDG PET/CT 预处理时的 NHOCpeak 可能是预测乳腺癌患者 NAC 反应和生存的潜在影像学参数。
