Details

Autor(en) / Beteiligte

• Chen, Zhenying
• Zheng, Shan
• Miao, Weibing

Titel

Application of 99mTc-3PRGD2 imaging for predicting pathological complete response to neoadjuvant chemotherapy in breast cancer and axillary lymph nodes

Ist Teil von

• The Journal of nuclear medicine (1978), 2018-05, Vol.59, p.1368

Ort / Verlag

New York: Society of Nuclear Medicine

Erscheinungsjahr

2018

Link zum Volltext

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Purpose: The aim of this study was to investigate the value of 99mTechnetium (99mTc)-three polyethylene glycol spacers (3P)-arginine-glycine-aspartic acid (RGD) (99mTc-3PRGD2) imaging for predicting pathological complete response (pCR) in primary breast tumors and metastatic axillary lymph nodes (ALN) after neoadjuvant chemotherapy (NAC) in locally advanced breast cancer, and to compare it with 18F-FDG PET/CT imaging. Methods: Forty-six patients with locally advanced-stage breast cancer were recruited for this prospective study. 99mTc-3PRGD2 SPECT and 18F-FDG PET/CT scans were performed before NAC (baseline), after the first and fifth cycle of NAC. The tumor-to-background (T/B) ratios of SPECT, standardized uptake values (SUVmax) of PET/CT in breast tumors and ALN metastases, and the relative changes of T/B (ΔT/B) and SUVmax (ΔSUVmax) regarding to the baseline scans were calculated. All patients underwent surgery after NAC, and the pathological response was used as the gold standard. Statistical analysis was carried out by the student’s t-test, receiver operating characteristic (ROC) analysis and Z test. Results: Forty-one patients who underwent 99mTc-3PRGD2 SPECT and 18F-FDG PET/CT scans were included in the final analysis. The pCR after NAC were achieved in 13 patients.The ΔT/B1 and ΔT/B2 and the ΔSUVmax1 in breast tumors were significantly greater in the pCR group than in the non-pCR group (P = 0.000, 0.041 and 0.000, respectively). In ROC analysis, the area under curve (AUC) of ΔT/B1 (0.827 ) in breast tumors after the first cycle of NAC for predicting pCR was not significantly different from that of ΔT/B2 after the fifth cycle (0.687) (Z = 1.22, P = 0.224). ROC-AUCs of ΔSUVmax1 and ΔSUVmax2 in breast tumors on PET/CT were 0.894 and 0.655, respectively (Z = 2.14, P = 0.033). No significant differences were found between the ΔT/B1 and ΔSUVmax1 in breast tumors for predicting pathological response to NAC after the first cycle (Z = 0.81, P = 0.420).For ALN metastases, the ΔT/B1, ΔT/B2 and ΔSUVmax2 in pCR group were significantly higher than those in non-pCR group (P = 0.000, 0.001 and 0.006, respectively). ROC-AUCs of ΔT/B for predicting pCR were 0.919 (ΔT/B1) and 0.778 (ΔT/B2), respectively. And the ROC-AUCs of ΔSUVmax were only 0.560 and 0.795, respectively. The AUC of ΔT/B1 in ALNs was greater than that of ΔSUVmax1 for predicting pCR after the first cycle of NAC (Z = 2.70, P = 0.007). Conclusions: 99mTc-3PRGD2 SPECT imaging and 18F-FDG PET/CT imaging showed a comparable early prediction of breast tumor pCR to NAC. And even the early metabolic change of ALNs on 99mTc-3PRGD2 SPECT imaging showed a higher predictve value for pCR. Therefore, 99mTc-3PRGD2 SPECT imaging is feasible for the early prediction pCR to NAC in locally advanced breast cancer patients.