Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography–Computed Tomography in Monitoring the Response of Breast Cancer to Neoadjuvant Chemotherapy: A Meta–Analysis

Mghanga, Fabian Pius; Lan, Xiaoli; Bakari, Khamis Hassan; Li, Chongjiao; Zhang, Yongxue

doi:10.1016/j.clbc.2013.02.003

Cited by 83 publications

(54 citation statements)

References 24 publications

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“…Discussion FDG-PET is increasingly being used as a biomarker for treatment monitoring in patients with cancer (13)(14)(15). To identify a metabolic response, it is necessary to establish the normal variation of tumor FDG uptake before therapeutic intervention.…”

Section: Resultsmentioning

confidence: 99%

Repeatability of Quantitative FDG-PET/CT and Contrast-Enhanced CT in Recurrent Ovarian Carcinoma: Test–Retest Measurements for Tumor FDG Uptake, Diameter, and Volume

Rockall

Avril

Lam

et al. 2014

Clinical Cancer Research

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Purpose: Repeatability of baseline FDG-PET/CT measurements has not been tested in ovarian cancer. This dual-center, prospective study assessed variation in tumor 2[18F]fluoro-2-deoxy-D-glucose (FDG) uptake, tumor diameter, and tumor volume from sequential FDG-PET/CT and contrast-enhanced computed tomography (CECT) in patients with recurrent platinum-sensitive ovarian cancer.Experimental Design: Patients underwent two pretreatment baseline FDG-PET/CT (n ¼ 21) and CECT (n ¼ 20) at two clinical sites with different PET/CT instruments. Patients were included if they had at least one target lesion in the abdomen with a standardized uptake value (SUV) maximum (SUVmax) of !2.5 and a long axis diameter of !15 mm. Two independent reading methods were used to evaluate repeatability of tumor diameter and SUV uptake: on site and at an imaging clinical research organization (CRO). Tumor volume reads were only performed by CRO. In each reading set, target lesions were independently measured on sequential imaging.Results: Median time between FDG-PET/CT was two days (range 1-7). For site reads, concordance correlation coefficients (CCC) for SUVmean, SUVmax, and tumor diameter were 0.95, 0.94, and 0.99, respectively. Repeatability coefficients were 16.3%, 17.3%, and 8.8% for SUVmean, SUVmax, and tumor diameter, respectively. Similar results were observed for CRO reads. Tumor volume CCC was 0.99 with a repeatability coefficient of 28.1%.Conclusions: There was excellent test-retest repeatability for FDG-PET/CT quantitative measurements across two sites and two independent reading methods. Cutoff values for determining change in SUVmean, SUVmax, and tumor volume establish limits to determine metabolic and/or volumetric response to treatment in platinum-sensitive relapsed ovarian cancer. Clin Cancer Res; 20(10); 2751-60. Ó2014 AACR.

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Section: Resultsmentioning

confidence: 99%

Repeatability of Quantitative FDG-PET/CT and Contrast-Enhanced CT in Recurrent Ovarian Carcinoma: Test–Retest Measurements for Tumor FDG Uptake, Diameter, and Volume

Rockall

Avril

Lam

et al. 2014

Clinical Cancer Research

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“…A review article including 745 patients in 15 studies indicated that the pooled sensitivity and specificity of FDG-PET for early separation of responders from non-responders could reach 80.5 % (95 % CI, 75.9-84.5 %) and 78.8 % (95 % CI, 74.1-83.0 %), respectively [91]. The review concluded that FDG-PET has moderately high sensitivity and specificity for early delineation of responders from non-responders, and can be applied for evaluating the response of breast cancer to neoadjuvant chemotherapy.…”

Section: Early Treatment Response Assessmentmentioning

confidence: 99%

Present and future role of FDG-PET/CT imaging in the management of breast cancer

Kitajima

Miyoshi

2016

Jpn J Radiol

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by malignant cells, opened a new field in clinical oncologic imaging. Recently, integrated positron emission tomography/computed tomography (PET/CT), in which a full-ringdetector clinical PET scanner and multidetector-row helical CT scanner are combined, has made it possible to acquire both metabolic and anatomic imaging data using a single device in a single diagnostic session, and provides precise anatomic localization of suspicious areas of increased FDG uptake. When used in a clinical setting, FDG-PET/CT leads to a significant improvement in diagnostic accuracy and has had a considerable impact on patient management, including diagnosis, initial staging, optimization of treatment, restaging, monitoring of the response to therapy, and prognostication of various malignant tumors. We herein review the current and future roles of FDG-PET/CT in the management of breast cancer, discussing its usefulness and limitations for imaging in these patients. DiagnosisFDG-PET imaging has poor sensitivity (<50 %) for subcentimeter breast cancers [9,10]. This is due to the limited spatial resolution of PET and, in some cases, by tumor characteristics (e.g., low FDG avidity in grade 1 cancer, ductal carcinoma in situ, or lobular carcinoma) [1,2]. Specificity can also be altered by variations of FDG uptake in certain benign conditions, such as infection, fibroadenoma, ductal adenoma, inflammatory granulomatous mastitis, and fibrocystic changes [3].In order to improve specificity, some authors would obtain a second series of PET images centered on the breast approximately 2 h after FDG injection (dual-time imaging) [4]. Indeed, FDG uptake seems to increase with time in the case of malignancy, while some inflammatory lesions show stable or decreasing uptake [4]. However, dual-time Abstract Integrated positron emission tomography/computed tomography (PET/CT) with 2-[18F]fluoro-2-deoxyd-glucose (FDG) is a useful tool for acquisition of both glucose metabolic and anatomic imaging data using a single device in a single diagnostic session, and has opened a new field in clinical oncologic imaging. FDG-PET/CT has been used successfully for the diagnosis, initial staging, restaging, early treatment response assessment, evaluation of metastatic disease response, and prognostication of breast cancer as well as various malignant tumors. We herein review the current place and role of FDG-PET/CT in the management of breast cancer, focusing on its usefulness and limitations in the imaging of these patients.

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“…It is approved as a diagnostic tool after mammography and is not indicated for screening or as an alternative to biopsy. Typical protocols specify an injection of 740-1,100 MBq (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) into the arm contralateral to the suspected abnormality. Imaging begins 5-10 min after injection, with 10 min per view.…”

Section: Single-photon G Imaging Systems For Dedicated Breast Imagingmentioning

confidence: 99%

“…A recent meta-analysis demonstrated moderately high sensitivity (80%) and specificity (79%) of whole-body 18 F-FDG PET or PET/CT in early differentiation of responders from nonresponders (20). Although there are no currently published reports of the use of PEM or dedicated breast PET for evaluating response to neoadjuvant chemotherapy, at least one clinical trial is under way (NCT01012440).…”

Section: Response To Neoadjuvant Therapymentioning

confidence: 99%

A Molecular Approach to Breast Imaging

Fowler

2014

J Nucl Med

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Molecular imaging is a multimodality discipline for noninvasively visualizing biologic processes at the subcellular level. Clinical applications of radionuclide-based molecular imaging for breast cancer continue to evolve. Whole-body imaging, with scintimammography and PET, and newer dedicated breast imaging systems are reviewed. The potential clinical indications and the challenges of implementing these emerging technologies are presented.

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Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography–Computed Tomography in Monitoring the Response of Breast Cancer to Neoadjuvant Chemotherapy: A Meta–Analysis

Cited by 83 publications

References 24 publications

Repeatability of Quantitative FDG-PET/CT and Contrast-Enhanced CT in Recurrent Ovarian Carcinoma: Test–Retest Measurements for Tumor FDG Uptake, Diameter, and Volume

Repeatability of Quantitative FDG-PET/CT and Contrast-Enhanced CT in Recurrent Ovarian Carcinoma: Test–Retest Measurements for Tumor FDG Uptake, Diameter, and Volume

Present and future role of FDG-PET/CT imaging in the management of breast cancer

A Molecular Approach to Breast Imaging

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