Dedicated breast PET for detecting residual disease after neoadjuvant chemotherapy in operable breast cancer: A prospective cohort study

Sasada, Shinsuke; Masumoto, Norio; Goda, Noriko; Kajitani, Keiko; Emi, Akiko; Kadoya, Takayuki; Okada, Morihito

doi:10.1016/j.ejso.2018.01.014

Cited by 18 publications

(10 citation statements)

References 22 publications

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“…The standard is to compare the longest diameter in images prior to and after NAC and to thereby evaluate the response. After NAC, the regression of tumor cells mainly manifests as necrosis and fibrosis of the lesions (32,33). Conventional ultrasound cannot accurately distinguish between necrosis, fibrous hyperplasia and residual cancer (34).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the response of breast cancer patients to neoadjuvant chemotherapy by combined contrast‑enhanced ultrasonography and ultrasound elastography

et al. 2019

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The purpose of the present study was to investigate whether contrast-enhanced ultrasonography (CEUS) in combination with ultrasound elastography (UE) is able to accurately predict the efficacy of neoadjuvant chemotherapy (NAC) in breast cancer patients. A total of 65 breast cancer patients who received NAC at the First Affiliated Hospital of Zhejiang University (Hangzhou, China) between February 2016 and August 2017 and were recruited for the present study. Prior to and after NAC, examination by CEUS, UE or their combination was performed. Pathological results were obtained at the end of each chemotherapy cycle, based on which 41 cases were assigned to the response group and 24 to the non-response group. Kappa values were 0.710, 0.434 and 0.836 for CEUS, UE and CEUS+UE, respectively. The area under the receiver operating characteristic curves for CEUS, UE and CEUS+UE for determining the response to NAC was 0.864 [95% confidence interval (CI), 0.765–0.964], 0.715 (95% CI, 0.579–0.850) and 0.910 (95% CI, 0.826–0.993), respectively. It was identified that the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of CEUS+UE were higher than those of CEUS and US individually. The prediction accuracy was 89.2, 90.8 and 100% for CEUS, UE and their combination, respectively. CEUS and UE have their own advantages in evaluating the clinical efficacy of NAC in breast cancer, and a higher accuracy was achieved when the two techniques were applied in combination. Therefore, a combination of CEUS and UE may be a preferred method for the clinical assessment of the efficacy of NAC in breast cancer patients.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the response of breast cancer patients to neoadjuvant chemotherapy by combined contrast‑enhanced ultrasonography and ultrasound elastography

et al. 2019

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“…In that study, sub-centimeter lesions in the ipsilateral breast were identified by dbPET that were not resolved in the wbPET images. Similarly, using the Elmammo system, Sasada et al compared bilateral [ 18 F]FDG-dbPET to [ 18 F]FDG-wbPET in a 47-patient cohort following NAC and observed that the tumor-background ratio was more sensitive than SUV max to treatment response 33 . Nishimatsu et al .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of primary breast cancers using dedicated breast PET and whole-body PET

Hathi

Seo

et al. 2020

Sci Rep

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Metabolic imaging of the primary breast tumor with 18F-fluorodeoxyglucose ([18F]FDG) PET may assist in predicting treatment response in the neoadjuvant chemotherapy (NAC) setting. Dedicated breast PET (dbPET) is a high-resolution imaging modality with demonstrated ability in highlighting intratumoral heterogeneity and identifying small lesions in the breast volume. In this study, we characterized similarities and differences in the uptake of [18F]FDG in dbPET compared to whole-body PET (wbPET) in a cohort of ten patients with biopsy-confirmed, locally advanced breast cancer at the pre-treatment timepoint. Patients received bilateral dbPET and wbPET following administration of 186 MBq and 307 MBq [18F]FDG on separate days, respectively. [18F]FDG uptake measurements and 20 radiomic features based on morphology, tumor intensity, and texture were calculated and compared. There was a fivefold increase in SULpeak for dbPET (median difference (95% CI): 4.0 mL−1 (1.8–6.4 mL−1), p = 0.006). Additionally, spatial heterogeneity features showed statistically significant differences between dbPET and wbPET. The higher [18F]FDG uptake in dbPET highlighted the dynamic range of this breast-specific imaging modality. Combining with the higher spatial resolution, dbPET may be able to detect treatment response in the primary tumor during NAC, and future studies with larger cohorts are warranted.

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“…The prospective study of Noritake et al compared PEM technique to whole-body (WB) 18 F-FDG-PET and PEM proved to better detect residual tumor, whereas it was not superior in predicting pCR, though only 20 patients were enrolled [52]. In a series including 47 patients, Sasada et al [53] concluded that PEM was more accurate than WB PET in detecting residual primary tumors after NAC, particularly intraductal carcinoma. Analogous results have been reported by the Japanese team of Koyasu [54] in 2018.…”

Section: Nuclear Medicine Techniquesmentioning

confidence: 99%

Assessment and Prediction of Response to Neoadjuvant Chemotherapy in Breast Cancer: A Comparison of Imaging Modalities and Future Perspectives

Romeo

Accardo

Perillo

et al. 2021

Cancers

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Neoadjuvant chemotherapy (NAC) is becoming the standard of care for locally advanced breast cancer, aiming to reduce tumor size before surgery. Unfortunately, less than 30% of patients generally achieve a pathological complete response and approximately 5% of patients show disease progression while receiving NAC. Accurate assessment of the response to NAC is crucial for subsequent surgical planning. Furthermore, early prediction of tumor response could avoid patients being overtreated with useless chemotherapy sections, which are not free from side effects and psychological implications. In this review, we first analyze and compare the accuracy of conventional and advanced imaging techniques as well as discuss the application of artificial intelligence tools in the assessment of tumor response after NAC. Thereafter, the role of advanced imaging techniques, such as MRI, nuclear medicine, and new hybrid PET/MRI imaging in the prediction of the response to NAC is described in the second part of the review. Finally, future perspectives in NAC response prediction, represented by AI applications, are discussed.

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Dedicated breast PET for detecting residual disease after neoadjuvant chemotherapy in operable breast cancer: A prospective cohort study

Cited by 18 publications

References 22 publications

Evaluation of the response of breast cancer patients to neoadjuvant chemotherapy by combined contrast‑enhanced ultrasonography and ultrasound elastography

Evaluation of the response of breast cancer patients to neoadjuvant chemotherapy by combined contrast‑enhanced ultrasonography and ultrasound elastography

Evaluation of primary breast cancers using dedicated breast PET and whole-body PET

Assessment and Prediction of Response to Neoadjuvant Chemotherapy in Breast Cancer: A Comparison of Imaging Modalities and Future Perspectives

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