Issn Print: 0143-3636
Publication Date: 2006/03/01
A62 FDG PET for prediction of chemotherapy response in primary breast cancer patients
G.M. McDermott; A. Welch; R.T. Staff; F.J. Gilbert; L. Schweiger; S.I.K. Semple; A.W. Hutcheon; I.D. Miller; I.C. Smith; S.D. Heys
+ Author Information
Author Information: School of Medical Sciences, University of Aberdeen
Excerpt
FDG PET imaging is emerging as an effective technique for predicting the pathologic response of breast tumours to neoadjuvant chemotherapy at an early stage. However, questions remain as to the optimal method to use for quantifying FDG uptake, the optimal point during therapy at which to acquire the images and the efficacy for a large patient population. In this study we address these questions by comparison of a number of FDG uptake parameters in a group of patients for whom images were acquired before therapy (n=96), after the first cycle (n=74), at the midpoint (n=58) and at the endpoint (n=66) of anthracycline-based chemotherapy. The results show that (1) FDG PET had no predictive power for response when image contrast was low; (2) there was little change in FDG uptake between the midpoint and end of therapy; and (3) no statistically significant improvement in predictive power after the first cycle. The best results were obtained for a population with a pre-therapy tumour to background ratio greater than 5, using the activity distribution in a background region of interest to define the active tumour volume. With this method a sensitivity of 100% and a specificity of 77% were achieved; although several methods produced similar results.
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