Monitoring primary breast cancer throughout chemotherapy using FDG-PET

Gary M. McDermott, Andrew Welch, Roger T Staff, Fiona Jane Gilbert, Lutz Frank Schweiger, Scott Ian Kay Semple, Timothy Andrew Davies Smith, Andrew W. Hutcheon, Iain D Miller, Ian C. Smith, Steven Darryll Heys

Research output: Contribution to journalArticle

87 Citations (Scopus)

Abstract

We have compared 2-deoxy-2-[18F]-fluoro-d-glucose positron emission tomography (FDG-PET) images of large or locally advanced breast cancers (LABC) acquired during Anthracycline-based chemotherapy. The purpose was to determine whether there is an optimal method for defining tumour volume and an optimal imaging time for predicting pathologic chemotherapy response. Method: PET data were acquired before the first and second cycles, at the midpoint and at the endpoint of neoadjuvant chemotherapy. FDG uptake was quantified using the mean and maximum standardized uptake values (SUV) and the coefficient of variation within a region of interest. Receiver-operator characteristic (ROC) analysis was used to determine the discrimination between tumours demonstrating a high pathological response (i.e. those with greater than 90% reduction in viable tumour cells) and low pathological response. Results: Only tumours with an initial tumour to background ratio (TBR) of greater than five showed a difference between response categories. In terms of response discrimination, there was no statistically significant advantage of any of the methods used for image quantification or any of the time points. The best discrimination was measured for mean SUV at the midpoint of therapy, which identified 77% of low responding tumours whilst correctly identifying 100% of high responding tumours and had an ROC area of 0.93. Conclusion: FDG-PET is efficacious for predicting the pathologic response of most primary breast tumours throughout the duration of a neoadjuvant chemotherapy regimen. However, this technique is ineffective for tumours with low image contrast on pre-therapy PET scans.
Original languageEnglish
Pages (from-to)75-84
Number of pages10
JournalBreast Cancer Research and Treatment
Volume102
Issue number1
Early online date9 Aug 2006
DOIs
Publication statusPublished - Mar 2007

Fingerprint

Positron-Emission Tomography
Breast Neoplasms
Glucose
Drug Therapy
Neoplasms
Anthracyclines
Tumor Burden
Therapeutics

Keywords

  • fluorodeoxyglucose
  • FDG-PET
  • locally advanced breast cancer
  • monitoring
  • neoadjuvant chemotherapy
  • positron emission tomography

Cite this

Monitoring primary breast cancer throughout chemotherapy using FDG-PET. / McDermott, Gary M.; Welch, Andrew; Staff, Roger T; Gilbert, Fiona Jane; Schweiger, Lutz Frank; Semple, Scott Ian Kay; Smith, Timothy Andrew Davies; Hutcheon, Andrew W.; Miller, Iain D; Smith, Ian C.; Heys, Steven Darryll.

In: Breast Cancer Research and Treatment, Vol. 102, No. 1, 03.2007, p. 75-84.

Research output: Contribution to journalArticle

McDermott, GM, Welch, A, Staff, RT, Gilbert, FJ, Schweiger, LF, Semple, SIK, Smith, TAD, Hutcheon, AW, Miller, ID, Smith, IC & Heys, SD 2007, 'Monitoring primary breast cancer throughout chemotherapy using FDG-PET', Breast Cancer Research and Treatment, vol. 102, no. 1, pp. 75-84. https://doi.org/10.1007/S10549-006-9316-7
McDermott, Gary M. ; Welch, Andrew ; Staff, Roger T ; Gilbert, Fiona Jane ; Schweiger, Lutz Frank ; Semple, Scott Ian Kay ; Smith, Timothy Andrew Davies ; Hutcheon, Andrew W. ; Miller, Iain D ; Smith, Ian C. ; Heys, Steven Darryll. / Monitoring primary breast cancer throughout chemotherapy using FDG-PET. In: Breast Cancer Research and Treatment. 2007 ; Vol. 102, No. 1. pp. 75-84.
@article{c71281e953164ee8bba157fe8fd22d9b,
title = "Monitoring primary breast cancer throughout chemotherapy using FDG-PET",
abstract = "We have compared 2-deoxy-2-[18F]-fluoro-d-glucose positron emission tomography (FDG-PET) images of large or locally advanced breast cancers (LABC) acquired during Anthracycline-based chemotherapy. The purpose was to determine whether there is an optimal method for defining tumour volume and an optimal imaging time for predicting pathologic chemotherapy response. Method: PET data were acquired before the first and second cycles, at the midpoint and at the endpoint of neoadjuvant chemotherapy. FDG uptake was quantified using the mean and maximum standardized uptake values (SUV) and the coefficient of variation within a region of interest. Receiver-operator characteristic (ROC) analysis was used to determine the discrimination between tumours demonstrating a high pathological response (i.e. those with greater than 90{\%} reduction in viable tumour cells) and low pathological response. Results: Only tumours with an initial tumour to background ratio (TBR) of greater than five showed a difference between response categories. In terms of response discrimination, there was no statistically significant advantage of any of the methods used for image quantification or any of the time points. The best discrimination was measured for mean SUV at the midpoint of therapy, which identified 77{\%} of low responding tumours whilst correctly identifying 100{\%} of high responding tumours and had an ROC area of 0.93. Conclusion: FDG-PET is efficacious for predicting the pathologic response of most primary breast tumours throughout the duration of a neoadjuvant chemotherapy regimen. However, this technique is ineffective for tumours with low image contrast on pre-therapy PET scans.",
keywords = "fluorodeoxyglucose, FDG-PET, locally advanced breast cancer, monitoring, neoadjuvant chemotherapy, positron emission tomography",
author = "McDermott, {Gary M.} and Andrew Welch and Staff, {Roger T} and Gilbert, {Fiona Jane} and Schweiger, {Lutz Frank} and Semple, {Scott Ian Kay} and Smith, {Timothy Andrew Davies} and Hutcheon, {Andrew W.} and Miller, {Iain D} and Smith, {Ian C.} and Heys, {Steven Darryll}",
year = "2007",
month = "3",
doi = "10.1007/S10549-006-9316-7",
language = "English",
volume = "102",
pages = "75--84",
journal = "Breast Cancer Research and Treatment",
issn = "0167-6806",
publisher = "Springer New York",
number = "1",

}

TY - JOUR

T1 - Monitoring primary breast cancer throughout chemotherapy using FDG-PET

AU - McDermott, Gary M.

AU - Welch, Andrew

AU - Staff, Roger T

AU - Gilbert, Fiona Jane

AU - Schweiger, Lutz Frank

AU - Semple, Scott Ian Kay

AU - Smith, Timothy Andrew Davies

AU - Hutcheon, Andrew W.

AU - Miller, Iain D

AU - Smith, Ian C.

AU - Heys, Steven Darryll

PY - 2007/3

Y1 - 2007/3

N2 - We have compared 2-deoxy-2-[18F]-fluoro-d-glucose positron emission tomography (FDG-PET) images of large or locally advanced breast cancers (LABC) acquired during Anthracycline-based chemotherapy. The purpose was to determine whether there is an optimal method for defining tumour volume and an optimal imaging time for predicting pathologic chemotherapy response. Method: PET data were acquired before the first and second cycles, at the midpoint and at the endpoint of neoadjuvant chemotherapy. FDG uptake was quantified using the mean and maximum standardized uptake values (SUV) and the coefficient of variation within a region of interest. Receiver-operator characteristic (ROC) analysis was used to determine the discrimination between tumours demonstrating a high pathological response (i.e. those with greater than 90% reduction in viable tumour cells) and low pathological response. Results: Only tumours with an initial tumour to background ratio (TBR) of greater than five showed a difference between response categories. In terms of response discrimination, there was no statistically significant advantage of any of the methods used for image quantification or any of the time points. The best discrimination was measured for mean SUV at the midpoint of therapy, which identified 77% of low responding tumours whilst correctly identifying 100% of high responding tumours and had an ROC area of 0.93. Conclusion: FDG-PET is efficacious for predicting the pathologic response of most primary breast tumours throughout the duration of a neoadjuvant chemotherapy regimen. However, this technique is ineffective for tumours with low image contrast on pre-therapy PET scans.

AB - We have compared 2-deoxy-2-[18F]-fluoro-d-glucose positron emission tomography (FDG-PET) images of large or locally advanced breast cancers (LABC) acquired during Anthracycline-based chemotherapy. The purpose was to determine whether there is an optimal method for defining tumour volume and an optimal imaging time for predicting pathologic chemotherapy response. Method: PET data were acquired before the first and second cycles, at the midpoint and at the endpoint of neoadjuvant chemotherapy. FDG uptake was quantified using the mean and maximum standardized uptake values (SUV) and the coefficient of variation within a region of interest. Receiver-operator characteristic (ROC) analysis was used to determine the discrimination between tumours demonstrating a high pathological response (i.e. those with greater than 90% reduction in viable tumour cells) and low pathological response. Results: Only tumours with an initial tumour to background ratio (TBR) of greater than five showed a difference between response categories. In terms of response discrimination, there was no statistically significant advantage of any of the methods used for image quantification or any of the time points. The best discrimination was measured for mean SUV at the midpoint of therapy, which identified 77% of low responding tumours whilst correctly identifying 100% of high responding tumours and had an ROC area of 0.93. Conclusion: FDG-PET is efficacious for predicting the pathologic response of most primary breast tumours throughout the duration of a neoadjuvant chemotherapy regimen. However, this technique is ineffective for tumours with low image contrast on pre-therapy PET scans.

KW - fluorodeoxyglucose

KW - FDG-PET

KW - locally advanced breast cancer

KW - monitoring

KW - neoadjuvant chemotherapy

KW - positron emission tomography

U2 - 10.1007/S10549-006-9316-7

DO - 10.1007/S10549-006-9316-7

M3 - Article

VL - 102

SP - 75

EP - 84

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

SN - 0167-6806

IS - 1

ER -