1
|
Hindié E. The EANM-SNMMI guideline on the role of [18F]FDG-PET/CT in breast cancer: Important milestones and perspectives for the future. Eur J Nucl Med Mol Imaging 2024; 51:2695-2700. [PMID: 38735885 DOI: 10.1007/s00259-024-06758-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Affiliation(s)
- Elif Hindié
- Service de Médecine Nucléaire, CHU de Bordeaux, Université de Bordeaux, Talence, F-33400, France.
- Institut Universitaire de France, 1 rue Descartes, Paris cedex 05, 75231, France.
- Nuclear Medicine Department, University Hospitals of Bordeaux, Pessac, 33604, France.
| |
Collapse
|
2
|
Castagnoli F, Mencel J, Ap Dafydd D, Gough J, Drake B, Mcaddy NC, Withey SJ, Riddell AM, Koh DM, Shur JD. Response Evaluation Criteria in Gastrointestinal and Abdominal Cancers: Which to Use and How to Measure. Radiographics 2024; 44:e230047. [PMID: 38662587 DOI: 10.1148/rg.230047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
As the management of gastrointestinal malignancy has evolved, tumor response assessment has expanded from size-based assessments to those that include tumor enhancement, in addition to functional data such as those derived from PET and diffusion-weighted imaging. Accurate interpretation of tumor response therefore requires knowledge of imaging modalities used in gastrointestinal malignancy, anticancer therapies, and tumor biology. Targeted therapies such as immunotherapy pose additional considerations due to unique imaging response patterns and drug toxicity; as a consequence, immunotherapy response criteria have been developed. Some gastrointestinal malignancies require assessment with tumor-specific criteria when assessing response, often to guide clinical management (such as watchful waiting in rectal cancer or suitability for surgery in pancreatic cancer). Moreover, anatomic measurements can underestimate therapeutic response when applied to molecular-targeted therapies or locoregional therapies in hypervascular malignancies such as hepatocellular carcinoma. In these cases, responding tumors may exhibit morphologic changes including cystic degeneration, necrosis, and hemorrhage, often without significant reduction in size. Awareness of pitfalls when interpreting gastrointestinal tumor response is required to correctly interpret response assessment imaging and guide appropriate oncologic management. Data-driven image analyses such as radiomics have been investigated in a variety of gastrointestinal tumors, such as identifying those more likely to respond to therapy or recur, with the aim of delivering precision medicine. Multimedia-enhanced radiology reports can facilitate communication of gastrointestinal tumor response by automatically embedding response categories, key data, and representative images. ©RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material.
Collapse
Affiliation(s)
- Francesca Castagnoli
- From the Departments of Radiology (F.C., D.a.D., N.C.M., S.J.W., A.M.R., D.M.K., J.D.S.), Oncology (J.M.), Radiotherapy (J.G.), and Nuclear Medicine (B.D.), Royal Marsden Hospital, Downs Road, Sutton SM2 5PT, UK; and Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK (F.C., D.M.K.)
| | - Justin Mencel
- From the Departments of Radiology (F.C., D.a.D., N.C.M., S.J.W., A.M.R., D.M.K., J.D.S.), Oncology (J.M.), Radiotherapy (J.G.), and Nuclear Medicine (B.D.), Royal Marsden Hospital, Downs Road, Sutton SM2 5PT, UK; and Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK (F.C., D.M.K.)
| | - Derfel Ap Dafydd
- From the Departments of Radiology (F.C., D.a.D., N.C.M., S.J.W., A.M.R., D.M.K., J.D.S.), Oncology (J.M.), Radiotherapy (J.G.), and Nuclear Medicine (B.D.), Royal Marsden Hospital, Downs Road, Sutton SM2 5PT, UK; and Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK (F.C., D.M.K.)
| | - Jessica Gough
- From the Departments of Radiology (F.C., D.a.D., N.C.M., S.J.W., A.M.R., D.M.K., J.D.S.), Oncology (J.M.), Radiotherapy (J.G.), and Nuclear Medicine (B.D.), Royal Marsden Hospital, Downs Road, Sutton SM2 5PT, UK; and Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK (F.C., D.M.K.)
| | - Brent Drake
- From the Departments of Radiology (F.C., D.a.D., N.C.M., S.J.W., A.M.R., D.M.K., J.D.S.), Oncology (J.M.), Radiotherapy (J.G.), and Nuclear Medicine (B.D.), Royal Marsden Hospital, Downs Road, Sutton SM2 5PT, UK; and Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK (F.C., D.M.K.)
| | - Naami Charlotte Mcaddy
- From the Departments of Radiology (F.C., D.a.D., N.C.M., S.J.W., A.M.R., D.M.K., J.D.S.), Oncology (J.M.), Radiotherapy (J.G.), and Nuclear Medicine (B.D.), Royal Marsden Hospital, Downs Road, Sutton SM2 5PT, UK; and Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK (F.C., D.M.K.)
| | - Samuel Joseph Withey
- From the Departments of Radiology (F.C., D.a.D., N.C.M., S.J.W., A.M.R., D.M.K., J.D.S.), Oncology (J.M.), Radiotherapy (J.G.), and Nuclear Medicine (B.D.), Royal Marsden Hospital, Downs Road, Sutton SM2 5PT, UK; and Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK (F.C., D.M.K.)
| | - Angela Mary Riddell
- From the Departments of Radiology (F.C., D.a.D., N.C.M., S.J.W., A.M.R., D.M.K., J.D.S.), Oncology (J.M.), Radiotherapy (J.G.), and Nuclear Medicine (B.D.), Royal Marsden Hospital, Downs Road, Sutton SM2 5PT, UK; and Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK (F.C., D.M.K.)
| | - Dow-Mu Koh
- From the Departments of Radiology (F.C., D.a.D., N.C.M., S.J.W., A.M.R., D.M.K., J.D.S.), Oncology (J.M.), Radiotherapy (J.G.), and Nuclear Medicine (B.D.), Royal Marsden Hospital, Downs Road, Sutton SM2 5PT, UK; and Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK (F.C., D.M.K.)
| | - Joshua David Shur
- From the Departments of Radiology (F.C., D.a.D., N.C.M., S.J.W., A.M.R., D.M.K., J.D.S.), Oncology (J.M.), Radiotherapy (J.G.), and Nuclear Medicine (B.D.), Royal Marsden Hospital, Downs Road, Sutton SM2 5PT, UK; and Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK (F.C., D.M.K.)
| |
Collapse
|
3
|
Ndlovu H, Lawal IO, Mokoala KMG, Sathekge MM. Imaging Molecular Targets and Metabolic Pathways in Breast Cancer for Improved Clinical Management: Current Practice and Future Perspectives. Int J Mol Sci 2024; 25:1575. [PMID: 38338854 PMCID: PMC10855575 DOI: 10.3390/ijms25031575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Breast cancer is the most frequently diagnosed cancer and leading cause of cancer-related deaths worldwide. Timely decision-making that enables implementation of the most appropriate therapy or therapies is essential for achieving the best clinical outcomes in breast cancer. While clinicopathologic characteristics and immunohistochemistry have traditionally been used in decision-making, these clinical and laboratory parameters may be difficult to ascertain or be equivocal due to tumor heterogeneity. Tumor heterogeneity is described as a phenomenon characterized by spatial or temporal phenotypic variations in tumor characteristics. Spatial variations occur within tumor lesions or between lesions at a single time point while temporal variations are seen as tumor lesions evolve with time. Due to limitations associated with immunohistochemistry (which requires invasive biopsies), whole-body molecular imaging tools such as standard-of-care [18F]FDG and [18F]FES PET/CT are indispensable in addressing this conundrum. Despite their proven utility, these standard-of-care imaging methods are often unable to image a myriad of other molecular pathways associated with breast cancer. This has stimulated interest in the development of novel radiopharmaceuticals targeting other molecular pathways and processes. In this review, we discuss validated and potential roles of these standard-of-care and novel molecular approaches. These approaches' relationships with patient clinicopathologic and immunohistochemical characteristics as well as their influence on patient management will be discussed in greater detail. This paper will also introduce and discuss the potential utility of novel PARP inhibitor-based radiopharmaceuticals as non-invasive biomarkers of PARP expression/upregulation.
Collapse
Affiliation(s)
- Honest Ndlovu
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria 0001, South Africa; (H.N.); (K.M.G.M.)
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Private Bag X169, Pretoria 0001, South Africa;
| | - Ismaheel O. Lawal
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Private Bag X169, Pretoria 0001, South Africa;
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA 30322, USA
| | - Kgomotso M. G. Mokoala
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria 0001, South Africa; (H.N.); (K.M.G.M.)
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Private Bag X169, Pretoria 0001, South Africa;
| | - Mike M. Sathekge
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria 0001, South Africa; (H.N.); (K.M.G.M.)
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Private Bag X169, Pretoria 0001, South Africa;
| |
Collapse
|
4
|
Bodin S, Peuker LC, Jestin E, Alves ID, Velasco V, Ait-Arsa I, Schollhammer R, Lamare F, Vimont D, MacGrogan G, Hindié E, Beck-Sickinger AG, Morgat C. Development of Radiopharmaceuticals for NPY Receptor-5 (Y5) Nuclear Imaging in Tumors by Synthesis of Specific Agonists and Investigation of Their Binding Mode. Bioconjug Chem 2023; 34:2014-2021. [PMID: 37556437 DOI: 10.1021/acs.bioconjchem.3c00313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
The neuropeptide-Y (NPY) family acts through four G protein-coupled receptor subtypes in humans, namely, Y1, Y2, Y4, and Y5. A growing body of evidence suggest the involvement of the NPY system in several cancers, notably the Y5 subtype, thus acting as a relevant target for the development of radiopharmaceuticals for imaging or targeted radionuclide therapy (TRT). Here, the [cPP(1-7),NPY(19-23),Ala31,Aib32,Gln34]hPP scaffold, further referred to as sY5ago, was modified with a DOTA chelator and radiolabeled with 68Ga and 111In and investigated in vitro and in vivo using the MCF-7 model. For in vivo studies, MCF-7 cells were orthotopically implanted in female nude mice and imaging with small animal positron emission tomography/computed tomography (μPET/CT) was performed. At the end of imaging, the mice were sacrificed. A scrambled version of sY5ago, which was also modified with a DOTA chelator, served as a negative control (DOTA-[Nle]sY5ago_scrambled). sY5ago and DOTA-sY5ago showed subnanomolar affinity toward the Y5 (0.9 ± 0.1 and 0.8 ± 0.1 nM, respectively) and a single binding site at the Y5 was identified. [68Ga]Ga-DOTA-sY5ago and [111In]In-DOTA-sY5ago were hydrophilic and showed high specific internalization (1.61 ± 0.75%/106 cells at 1 h) and moderate efflux (55% of total binding externalized at 45 min). On μPET/CT images, most of the signal was depicted in the kidneys and the liver. MCF-7 tumors were clearly visualized. On biodistribution studies, [68Ga]Ga-DOTA-sY5ago was eliminated by the kidneys (∼60 %ID/g). The kidney uptake is Y5-mediated. A specific uptake was also noted in the liver (5.09 ± 1.15 %ID/g vs 1.13 ± 0.21 %ID/g for [68Ga]Ga-DOTA-[Nle]sY5ago_scrambled, p < 0.05), the lungs (1.03 ± 0.34 %ID/g vs 0.20 %ID/g, p < 0.05), and the spleen (0.85 ± 0.09%ID/g vs 0.16 ± 0.16%ID/g, p < 0.05). In MCF-7 tumors, [68Ga]Ga-DOTA-sY5ago showed 12-fold higher uptake than [68Ga]Ga-DOTA-[Nle]sY5ago_scrambled (3.43 ± 2.32 vs 0.27 ± 0.15 %ID/g, respectively, p = 0.0008) at 1 h post-injection. Finally, a proof-of-principle tissular micro-imaging study on a human primary cancer sample showed weak binding of [111In]In-DOTA-sY5ago in prostatic intra-neoplasia and high binding in the ISUP1 lesion while normal prostate was free of signal.
Collapse
Affiliation(s)
- Sacha Bodin
- Department of Nuclear Medicine, University Hospital of Bordeaux, F-33076 Bordeaux, France
- CNRS, EPHE, INCIA UMR 5287, University of Bordeaux, F-33400 Talence, France
| | - Lisa C Peuker
- Institute of Biochemistry, Faculty of Life Sciences, Leipzig University, Brüderstr. 34, 04103 Leipzig, Germany
| | - Emmanuelle Jestin
- GIP CYROI - Cyclotron Réunion Océan Indien, F-97490 Saint Clotilde, France
| | - Isabel D Alves
- CNRS UMR 248, Institute of Chemistry & Biology of Membranes & Nano-objects (CBMN), University of Bordeaux, F-33600 Pessac, France
| | - Valérie Velasco
- Surgical Pathology Unit, Department of Biopathology, Institut Bergonié, F-33076 Bordeaux, France
- ACTION U1218, INSERM, F-33076 Bordeaux, France
| | - Imade Ait-Arsa
- GIP CYROI - Cyclotron Réunion Océan Indien, F-97490 Saint Clotilde, France
| | - Romain Schollhammer
- Department of Nuclear Medicine, University Hospital of Bordeaux, F-33076 Bordeaux, France
- CNRS, EPHE, INCIA UMR 5287, University of Bordeaux, F-33400 Talence, France
| | - Frédéric Lamare
- CNRS, EPHE, INCIA UMR 5287, University of Bordeaux, F-33400 Talence, France
| | - Delphine Vimont
- CNRS, EPHE, INCIA UMR 5287, University of Bordeaux, F-33400 Talence, France
| | - Gaétan MacGrogan
- Surgical Pathology Unit, Department of Biopathology, Institut Bergonié, F-33076 Bordeaux, France
- ACTION U1218, INSERM, F-33076 Bordeaux, France
| | - Elif Hindié
- Department of Nuclear Medicine, University Hospital of Bordeaux, F-33076 Bordeaux, France
- CNRS, EPHE, INCIA UMR 5287, University of Bordeaux, F-33400 Talence, France
- Institut Universitaire de France, F-75000 Paris, France
| | - Annette G Beck-Sickinger
- Institute of Biochemistry, Faculty of Life Sciences, Leipzig University, Brüderstr. 34, 04103 Leipzig, Germany
| | - Clément Morgat
- Department of Nuclear Medicine, University Hospital of Bordeaux, F-33076 Bordeaux, France
- CNRS, EPHE, INCIA UMR 5287, University of Bordeaux, F-33400 Talence, France
| |
Collapse
|
5
|
Groheux D. Breast Cancer Systemic Staging (Comparison of Computed Tomography, Bone Scan, and 18F-Fluorodeoxyglucose PET/Computed Tomography). PET Clin 2023; 18:503-515. [PMID: 37268506 DOI: 10.1016/j.cpet.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
After an overview of the principles of bone scintigraphy, contrast-enhanced computed tomography (CE-CT) and 18F-fluorodeoxyglucose (FDG)-PET/CT, the advantages and limits of these modalities in the staging of breast cancer are discussed in this paper. CT and PET/CT are not optimal for delineating primary tumor volume, and PET is less efficient than the sentinel node biopsy to depict small axillary lymph node metastases. In large breast cancer tumor, FDG PET/CT is useful to show extra-axillary lymph nodes. FDG PET/CT is superior to bone scan and CE-CT in detecting distant metastases, and it results in a change of treatment plan in nearly 15% of patients.
Collapse
Affiliation(s)
- David Groheux
- Department of Nuclear Medicine, Saint-Louis Hospital, Paris, France; University Paris-Diderot, INSERM U976, HIPI, Paris, France; Centre d'Imagerie Radio-isotopique, La Rochelle, France.
| |
Collapse
|
6
|
Yadav D, Kumar R, Phulia A, Basu S, Alavi A. Molecular Imaging Assessment of Hormonally Sensitive Breast Cancer: An Appraisal of 2-[18F]-Fluoro-2-Deoxy-Glucose and Newer Non-2-[18F]-Fluoro-2-Deoxy-Glucose PET Tracers. PET Clin 2022; 17:399-413. [PMID: 35717099 DOI: 10.1016/j.cpet.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Hormone-sensitive breast cancer, which demonstrates hormone receptor positivity, accounts for approximately 75% of newly diagnosed breast cancer. 2-[18F]-Fluoro-2-deoxy-glucose is the nonspecific radiotracer of glucose metabolism as opposed to specific receptor based tracers like 16α-[18F]-fluoro-17β-estradiol and [18F]-fluoro-furanyl-norprogesterone, which provide essential information about receptor status in the management of hormonally active malignancies. The complementary information provided by (a) 2-[18F]-fluoro-2-deoxy-glucose imaging for staging and prognostication along with (b) analyzing the hormonal receptor status with receptor-based PET imaging in breast cancer can optimize tumor characterization and influence patient management.
Collapse
Affiliation(s)
- Divya Yadav
- MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Rakesh Kumar
- Division of Diagnostic Nuclear Medicine, Department of Nuclear Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
| | - Ankita Phulia
- Maulana Azad Medical College, New Delhi, 110002, India
| | - Sandip Basu
- Radiation Medicine Centre (B.A.R.C), Tata Memorial Centre Annexe, Parel, Mumbai; Homi Bhabha National Institute, Mumbai, India
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
7
|
Groheux D. FDG-PET/CT for Primary Staging and Detection of Recurrence of Breast Cancer. Semin Nucl Med 2022; 52:508-519. [PMID: 35636977 DOI: 10.1053/j.semnuclmed.2022.05.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 05/04/2022] [Indexed: 12/22/2022]
Abstract
Breast cancer is the most frequent cancer diagnosed in women worldwide. Accurate baseline staging is necessary to plan optimal breast cancer management. Early detection and staging of recurrence are also essential for optimal therapeutic management. Hybrid FDG-PET/CT imaging offers high sensitivity in detecting extra axillary lymph nodes and distant metastases. Although FDG-PET/CT has some limitations for low proliferative tumors, low-grade tumors and for well-differentiated luminal breast cancer, PET/CT is useful for the initial staging of breast cancer, regardless of tumor phenotype (luminal, triple negative, or HER2+) and of tumor grade. Although FDG-PET/CT performs better for invasive ductal carcinoma (invasive carcinoma of no specific subtype), it is also helpful for staging invasive lobular carcinomas. At initial staging, FDG-PET/CT becomes very useful for staging from clinical stage IIB (T2N1 or T3N0). FDG-PET/CT could be useful in patients with clinical stage IIA (T1N1 or T2N0), but there is not enough strong evidence to recommend routine use in this subgroup. For clinical stage I (T1N0) patients, FDG-PET/CT offers no added value. In patients with recurrent breast cancer, FDG-PET/CT is more effective than conventional imaging in detecting locoregional or distant recurrence, whether suspected by clinical examination, conventional imaging, or elevation of a tumor marker (CA 15.3 or CEA). PET/CT is effective even in the presence of normal tumor markers. PET/CT is also a powerful imaging modality for performing a whole-body workup of a known recurrence and for determining whether or not the recurrence is isolated.
Collapse
Affiliation(s)
- David Groheux
- Department of Nuclear Medicine, Saint-Louis Hospital, Paris, France; University Paris-Diderot, INSERM U976, HIPI, Paris, France; Centre d'Imagerie Radio-isotopique, La Rochelle, France.
| |
Collapse
|
8
|
Choi B. Comparison of Ultrasound Features With Maximum Standardized Uptake Value Assessed by 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography for Prognosis of Estrogen Receptor+/Human Epithelial Growth Factor Receptor 2- Breast Cancer. Ultrasound Q 2021; 38:18-24. [PMID: 35239627 DOI: 10.1097/ruq.0000000000000573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT estrogen receptor (ER)+/human epithelial growth factor receptor 2 (HER2)- breast cancers have less aggressive traits and a favorable prognosis when treated early. Prediction of prognosis for treatment outcome or survival in ER+/HER2- cancer is important. Ultrasound (US) is an effective and easy technique for breast cancer diagnosis and tumor characterization. Positron emission tomography/computed tomography (PET/CT) is widely used for diagnosis, staging, and therapeutic response in cancer evaluation, and a high maximum standardized uptake value (SUVmax) is associated with poor prognosis. The study aim was to compare the prognostic value of US features with that of the SUVmax assessed by PET/CT in ER+/HER- breast cancer patients. We retrospectively identified breast cancer patients in our institutional database who had undergone preoperative US and PET/CT, and 96 patients with invasive ductal carcinoma and ductal carcinoma in situ were included in this study. The US features of mass shape, margin, echo pattern, orientation, posterior features, boundary, and calcification in the mass were analyzed. We then analyzed the US features to look for correlations with SUVmax and associations with margins, boundaries, posterior features, histological grade, and ki-67 expression. High SUVmax was correlated with irregular shape, not-circumscribed margin, posterior acoustic enhancement, echogenic halo, and calcification in the mass (P < 0.05, all). Posterior acoustic enhancement was correlated with high ki-67 expression. Many US features of ER+/HER- breast cancer showed associations with SUVmax. Some US features of ER+/HER- breast cancer were useful for predicting prognosis.
Collapse
Affiliation(s)
- Bobae Choi
- Department of Radiology, Chungnam National University Hospital, Jung-gu, Daejeon, Republic of Korea
| |
Collapse
|
9
|
Radionuclide-Based Imaging of Breast Cancer: State of the Art. Cancers (Basel) 2021; 13:cancers13215459. [PMID: 34771622 PMCID: PMC8582396 DOI: 10.3390/cancers13215459] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/14/2021] [Accepted: 10/14/2021] [Indexed: 12/21/2022] Open
Abstract
Simple Summary Breast cancer is one of the most commonly diagnosed malignant tumors, possessing high incidence and mortality rates that threaten women’s health. Thus, early and effective breast cancer diagnosis is crucial for enhancing the survival rate. Radionuclide molecular imaging displays its advantages for detecting breast cancer from a functional perspective. Noninvasive visualization of biological processes with radionuclide-labeled small metabolic compounds helps elucidate the metabolic state of breast cancer, while radionuclide-labeled ligands/antibodies for receptor-targeted radionuclide molecular imaging is sensitive and specific for visualization of the overexpressed molecular markers in breast cancer. This review focuses on the most recent developments of novel radiotracers as promising tools for early breast cancer diagnosis. Abstract Breast cancer is a malignant tumor that can affect women worldwide and endanger their health and wellbeing. Early detection of breast cancer can significantly improve the prognosis and survival rate of patients, but with traditional anatomical imagine methods, it is difficult to detect lesions before morphological changes occur. Radionuclide-based molecular imaging based on positron emission tomography (PET) and single-photon emission computed tomography (SPECT) displays its advantages for detecting breast cancer from a functional perspective. Radionuclide labeling of small metabolic compounds can be used for imaging biological processes, while radionuclide labeling of ligands/antibodies can be used for imaging receptors. Noninvasive visualization of biological processes helps elucidate the metabolic state of breast cancer, while receptor-targeted radionuclide molecular imaging is sensitive and specific for visualization of the overexpressed molecular markers in breast cancer, contributing to early diagnosis and better management of cancer patients. The rapid development of radionuclide probes aids the diagnosis of breast cancer in various aspects. These probes target metabolism, amino acid transporters, cell proliferation, hypoxia, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), gastrin-releasing peptide receptor (GRPR) and so on. This article provides an overview of the development of radionuclide molecular imaging techniques present in preclinical or clinical studies, which are used as tools for early breast cancer diagnosis.
Collapse
|
10
|
Groheux D, Hindie E. Breast cancer: initial workup and staging with FDG PET/CT. Clin Transl Imaging 2021; 9:221-231. [PMID: 33937141 PMCID: PMC8075837 DOI: 10.1007/s40336-021-00426-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 04/13/2021] [Indexed: 12/13/2022]
Abstract
Purpose Precise staging is needed to plan optimal management in breast cancer. 18F-fluorodeoxyglucose positron emission tomography coupled with computed tomography (FDG-PET/CT) offers high sensitivity in detecting extra axillary lymph nodes and distant metastases. This review aims to clarify in which groups of patients staging with FDG-PET/CT would be beneficial and should be offered. We also discuss how tumor biology and breast cancer subtypes should be taken into account when interpreting FDG-PET/CT scans. Methods We performed a comprehensive literature review and rigorous appraisal of research studies assessing indications for FDG-PET/CT in breast cancer. This assessment regarding breast cancer served as a basis for the recommendations set by a working group of the French Society of Nuclear Medicine, in collaboration with oncological societies, for developing good clinical practice recommendations on the use of FDG-PET/CT in oncology. Results FDG-PET/CT is useful for initial staging of breast cancer, independently of tumor phenotype (triple negative, luminal or HER2 +) and regardless of tumor grade. Considering histological subtype, FDG-PET/CT performs better for staging invasive ductal carcinoma, although it is also helpful for staging invasive lobular carcinomas. Based on the available data, FDG-PET/CT becomes useful for staging starting from clinical stage IIB. FDG-PET/CT is possibly useful in patients with clinical stage IIA (T1N1 or T2N0), but there is not enough strong data to recommend routine use in this subgroup. For clinical stage I (T1N0) patients, staging with FDG-PET/CT offers no added value. Conclusion FDG-PET/CT is useful for staging patients with breast cancer, starting from clinical stage IIB.
Collapse
Affiliation(s)
- David Groheux
- Department of Nuclear Medicine, Saint-Louis Hospital, Paris, France
- University Paris-Diderot, INSERM U976, HIPI, Paris, France
| | - Elif Hindie
- Department of Nuclear Medicine, Bordeaux University Hospital, Bordeaux, France
| |
Collapse
|
11
|
Prognostic value of 18F-FDG PET and PET/CT for assessment of treatment response to neoadjuvant chemotherapy in breast cancer: a systematic review and meta-analysis. Breast Cancer Res 2020; 22:119. [PMID: 33129348 PMCID: PMC7603771 DOI: 10.1186/s13058-020-01350-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 10/05/2020] [Indexed: 12/20/2022] Open
Abstract
Background We performed a systematic review and meta-analysis to evaluate the prognostic significance of 18F-FDG PET and PET/CT for evaluation of responses to neoadjuvant chemotherapy (NAC) in breast cancer patients. Methods We searched PubMed, Embase, and the Cochrane Library databases until June 2020 to identify studies that assessed the prognostic value of 18F-FDG PET scans during or after NAC with regard to overall (OS) and disease-free survival (DFS). Hazard ratios (HRs) and their 95% confidence intervals (CIs) were pooled meta-analytically using a random-effects model. Results Twenty-one studies consisting of 1630 patients were included in the qualitative synthesis. Twelve studies investigated the use of PET scans for interim response evaluation (during NAC) and 10 studies assessed post-treatment PET evaluation (after NAC). The most widely evaluated parameter distinguishing metabolic responders from poor responders on interim or post-treatment PET scans was %ΔSUVmax, defined as the percent reduction of SUVmax compared to baseline PET, followed by SUVmax and complete metabolic response (CMR). For the 17 studies included in the meta-analysis, the pooled HR of metabolic responses on DFS was 0.21 (95% confidence interval [CI], 0.14–0.32) for interim PET scans and 0.31 (95% CI, 0.21–0.46) for post-treatment PET scans. Regarding the influence of metabolic responses on OS, the pooled HRs for interim and post-treatment PET scans were 0.20 (95% CI, 0.09–0.44) and 0.26 (95% CI, 0.14–0.51), respectively. Conclusions The currently available literature suggests that the use of 18F-FDG PET or PET/CT for evaluation of response to NAC provides significant predictive value for disease recurrence and survival in breast cancer patients and might allow risk stratification and guide rational management.
Collapse
|
12
|
Salaün PY, Abgral R, Malard O, Querellou-Lefranc S, Quere G, Wartski M, Coriat R, Hindie E, Taieb D, Tabarin A, Girard A, Grellier JF, Brenot-Rossi I, Groheux D, Rousseau C, Deandreis D, Alberini JL, Bodet-Milin C, Itti E, Casasnovas O, Kraeber-Bodere F, Moreau P, Philip A, Balleyguier C, Luciani A, Cachin F. Good clinical practice recommendations for the use of PET/CT in oncology. Eur J Nucl Med Mol Imaging 2019; 47:28-50. [PMID: 31637482 DOI: 10.1007/s00259-019-04553-8] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 09/24/2019] [Indexed: 12/27/2022]
Abstract
Positron emission tomography/computed tomography (PET/CT) is a nuclear medicine functional imaging technique with proven clinical value in oncology. PET/CT indications are continually evolving with fresh advances made through research. French practice on the use of PET in oncology was framed in recommendations based on Standards-Options-Recommendations methodology and coordinated by the French federation of Comprehensive Cancer Centres (FNLCC). The recommendations were originally issued in 2002 followed by an update in 2003, but since then, a huge number of scientific papers have been published and new tracers have been licenced for market release. The aim of this work is to bring the 2003 version recommendations up to date. For this purpose, a focus group was set up in collaboration with the French Society for Nuclear Medicine (SFMN) to work on developing good clinical practice recommendations. These good clinical practice recommendations have been awarded joint French National Heath Authority (HAS) and French Cancer Institute (INCa) label status-the stamp of methodological approval. The present document is the outcome of comprehensive literature review and rigorous appraisal by a panel of experts, organ specialists, clinical oncologists, surgeons and imaging specialists. These data were also used for the EANM referral guidelines.
Collapse
Affiliation(s)
- Pierre-Yves Salaün
- Department of Nuclear Medicine, University Hospital of Brest, 5 Avenue Foch, 29609, Brest, France.
| | - Ronan Abgral
- Department of Nuclear Medicine, University Hospital of Brest, 5 Avenue Foch, 29609, Brest, France
| | - Olivier Malard
- Head and Neck, University Hospital of Nantes, Nantes, France
| | - Solène Querellou-Lefranc
- Department of Nuclear Medicine, University Hospital of Brest, 5 Avenue Foch, 29609, Brest, France
| | - Gilles Quere
- Thoracic Oncology, University Hospital of Brest, Brest, France
| | | | - Romain Coriat
- Gastroenterology, Cochin Hospital AP-HP, Paris, France
| | - Elif Hindie
- Nuclear Medicine, University Hospital of Bordeaux, Bordeaux, France
| | | | - Antoine Tabarin
- Endocrinology, University Hospital of Bordeaux, Bordeaux, France
| | | | | | | | - David Groheux
- Nuclear Medicine, Hopital Saint Louis AP-HP, Paris, France
| | | | - Désirée Deandreis
- Nuclear Medicine, Department of Medical Sciences, Citta della Salute e della Scienza, Turin, Italy
| | - Jean-Louis Alberini
- Nuclear Medicine, Georges-François Leclerc center - François Mitterrand University Hospital, Dijon, France
| | | | - Emmanuel Itti
- Nuclear Medicine, Henri Mondor Hospital AP-HP, Paris, France
| | | | - Françoise Kraeber-Bodere
- Nuclear Medicine, Ouest Cancer Institute, Nantes, France.,Nuclear Medicine, University Hospital of Nantes, Nantes, France
| | | | - Arnaud Philip
- Centre du traitement de la douleur, CHRU de Brest, Brest, France
| | | | - Alain Luciani
- Radiology, Henri Mondor Hospital AP-HP, Paris, France
| | - Florent Cachin
- Nuclear Medicine, Jean Perrin Cancer Institute, Clermont-Ferrand, France
| |
Collapse
|
13
|
Chang CC, Chen CJ, Hsu WL, Chang SM, Huang YF, Tyan YC. Prognostic Significance of Metabolic Parameters and Textural Features on 18F-FDG PET/CT in Invasive Ductal Carcinoma of Breast. Sci Rep 2019; 9:10946. [PMID: 31358786 PMCID: PMC6662792 DOI: 10.1038/s41598-019-46813-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 06/25/2019] [Indexed: 12/19/2022] Open
Abstract
To investigate the prognostic significance of metabolic parameters and texture analysis on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in patients with breast invasive ductal carcinoma (IDC), from August 2005 to May 2015, IDC patients who had undergone pre-treatment FDG PET/CT were enrolled. The metabolic parameters, including maximal standardized uptake value of breast tumor (SUVbt) and ipsilateral axillary lymph node (SUVln), metabolic tumor volume (MTVbt) and total lesion glycolysis (TLGbt) of breast tumor, whole-body MTV (MTVwb) and whole-body TLG (TLGwb) were recorded. Nine textural features of tumor (four co-occurrence matrices and five SUV-based statistics) were measured. The prognostic significance of above parameters and clinical factors was assessed by univariate and multivariate analyses. Thirty-five patients were enrolled. Patients with low and high MTVwb had 5-year progression-free survival (PFS) of 81.0 and 14.3% (p < 0.0001). The 5-year overall survival for low and high MTVwb was 88.5% and 43.6% (p = 0.0005). Multivariate analyses showed MTVwb was an independent prognostic factor for PFS (HR: 8.29, 95% CI: 2.17–31.64, p = 0.0020). The SUV, TLG and textural features were not independently predictive. Elevated MTVwb was an independent predictor for shorter PFS in patients with breast IDC.
Collapse
Affiliation(s)
- Chin-Chuan Chang
- Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan.,Neuroscience Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chao-Jung Chen
- Departments of Nuclear Medicine, Yuan's General Hospital, Kaohsiung, Taiwan.,Department of Health Business Administration, Meiho University, Pingtung, Taiwan
| | - Wen-Ling Hsu
- Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Min Chang
- Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ying-Fong Huang
- Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Chang Tyan
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan. .,Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan. .,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. .,Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung, Taiwan. .,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
| |
Collapse
|
14
|
Combination of breast imaging parameters obtained from 18F-FDG PET and CT scan can improve the prediction of breast-conserving surgery after neoadjuvant chemotherapy in luminal/HER2-negative breast cancer. Eur J Radiol 2019; 113:81-88. [DOI: 10.1016/j.ejrad.2019.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 01/09/2019] [Accepted: 02/04/2019] [Indexed: 11/20/2022]
|
15
|
Actualisation des recommandations de bonne pratique clinique pour l’utilisation de la TEP en cancérologie. Bull Cancer 2019; 106:262-274. [DOI: 10.1016/j.bulcan.2019.01.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 11/19/2018] [Indexed: 11/22/2022]
|
16
|
Surov A, Meyer HJ, Wienke A. Associations Between PET Parameters and Expression of Ki-67 in Breast Cancer. Transl Oncol 2019; 12:375-380. [PMID: 30522044 PMCID: PMC6279710 DOI: 10.1016/j.tranon.2018.11.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 11/13/2018] [Accepted: 11/13/2018] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Numerous studies investigated relationships between positron emission tomography and proliferation index Ki-67 in breast cancer (BC) with inconsistent results. The aim of the present analysis was to provide evident data about associations between standardized uptake value (SUV) and expression of Ki-67 in BC. METHODS MEDLINE library, SCOPUS and EMBASE data bases were screened for relationships between SUV and Ki-67 in BC up to April 2018. Overall, 32 studies with 1802 patients were identified. The following data were extracted from the literature: authors, year of publication, number of patients, and correlation coefficients. Associations between SUV and Ki-67 were analyzed by Spearman's correlation coefficient. RESULTS Associations between SUVmax derived from 18F-FDG PET and Ki-67 were reported in 25 studies (1624 patients). The pooled correlation coefficient was 0.40, (95% CI = [0.34; 0.46]). Furthermore, 7 studies analyzed associations between SUVmax derived from 18F-fluorthymidin (FLT) PET and Ki-67 (178 patients). The pooled correlation coefficient was 0.54, (95% CI = [0.37; 0.70]). CONCLUSION SUVmax correlated moderately with expression of Ki-67 and, therefore, cannot be used as a surrogate marker for tumor proliferation. Further studies are needed to evaluate associations between PET parameters and histopathological findings like hormone receptor status in breast cancer.
Collapse
Affiliation(s)
- Alexey Surov
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Liebigstr. 20, 04103 Leipzig, Germany.
| | - Hans Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Liebigstr. 20, 04103 Leipzig, Germany.
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Str., 06097 Halle, Germany.
| |
Collapse
|
17
|
Morgat C, Schollhammer R, Macgrogan G, Barthe N, Vélasco V, Vimont D, Cazeau AL, Fernandez P, Hindié E. Comparison of the binding of the gastrin-releasing peptide receptor (GRP-R) antagonist 68Ga-RM2 and 18F-FDG in breast cancer samples. PLoS One 2019; 14:e0210905. [PMID: 30645633 PMCID: PMC6333408 DOI: 10.1371/journal.pone.0210905] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 01/03/2019] [Indexed: 12/30/2022] Open
Abstract
The Gastrin-Releasing Peptide Receptor (GRPR) is over-expressed in estrogen receptor (ER) positive breast tumors and related metastatic lymph nodes offering the opportunity of imaging and therapy of luminal tumors. 68Ga-RM2 binding and 18F-FDG binding in tumoral zones were measured and compared using tissue micro-imaging with a beta imager on 14 breast cancer samples (10 primaries and 4 associated metastatic lymph nodes). Results were then assessed against ER expression, progesterone receptor (PR) expression, HER2 over-expression or not and Ki-67 expression. GRPR immunohistochemistry (IHC) was also performed on all samples. We also retrospectively compared 68Ga-RM2 and 18F-FDG bindings to 18F-FDG SUVmax on the pre-therapeutic PET/CT examination, if available. 68Ga-RM2 binding was significantly higher in tumors expressing GRPR on IHC than in GRPR-negative tumors (P = 0.022). In ER+ tumors, binding of 68Ga-RM2 was significantly higher than 18F-FDG (P = 0.015). In tumors with low Ki-67, 68Ga-RM2 binding was also significantly increased compared to 18F-FDG (P = 0.029). Overall, the binding of 68Ga-RM2 and 18F-FDG displayed an opposite pattern in tumor samples and 68Ga-RM2 binding was significantly higher in tumors that had low 18F-FDG binding (P = 0.021). This inverse correlation was also documented in the few patients in whom a 18F-FDG PET/CT examination before surgery was available. Findings from this in vitro study suggest that GRPR targeting can be an alternative to 18F-FDG imaging in ER+ breast tumors. Moreover, because GRPR antagonists can also be labeled with lutetium-177 this opens new avenues for targeted radionuclide therapy in the subset of patients with progressive metastatic disease following conventional treatments.
Collapse
Affiliation(s)
- Clément Morgat
- Nuclear Medicine Department, University Hospital of Bordeaux, Bordeaux, France
- Univ. Bordeaux, INCIA, UMR-CNRS 5287, Talence, France
- CNRS, INCIA, UMR 5287, Talence, France
- * E-mail:
| | - Romain Schollhammer
- Nuclear Medicine Department, University Hospital of Bordeaux, Bordeaux, France
- Univ. Bordeaux, INCIA, UMR-CNRS 5287, Talence, France
- CNRS, INCIA, UMR 5287, Talence, France
| | - Gaétan Macgrogan
- Surgical Pathology Unit, Department of BioPathology, Institut Bergonié, Bordeaux, France
- INSERM, ACTION U1218, Bordeaux, France
| | | | - Valérie Vélasco
- Surgical Pathology Unit, Department of BioPathology, Institut Bergonié, Bordeaux, France
- INSERM, ACTION U1218, Bordeaux, France
| | - Delphine Vimont
- Univ. Bordeaux, INCIA, UMR-CNRS 5287, Talence, France
- CNRS, INCIA, UMR 5287, Talence, France
| | | | - Philippe Fernandez
- Nuclear Medicine Department, University Hospital of Bordeaux, Bordeaux, France
- Univ. Bordeaux, INCIA, UMR-CNRS 5287, Talence, France
- CNRS, INCIA, UMR 5287, Talence, France
| | - Elif Hindié
- Nuclear Medicine Department, University Hospital of Bordeaux, Bordeaux, France
- Univ. Bordeaux, INCIA, UMR-CNRS 5287, Talence, France
- CNRS, INCIA, UMR 5287, Talence, France
| |
Collapse
|
18
|
Clinical and Pre-clinical Methods for Quantifying Tumor Hypoxia. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1136:19-41. [PMID: 31201714 DOI: 10.1007/978-3-030-12734-3_2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Hypoxia, a prevalent characteristic of most solid malignant tumors, contributes to diminished therapeutic responses and more aggressive phenotypes. The term hypoxia has two definitions. One definition would be a physiologic state where the oxygen partial pressure is below the normal physiologic range. For most normal tissues, the normal physiologic range is between 10 and 20 mmHg. Hypoxic regions develop when there is an imbalance between oxygen supply and demand. The impact of hypoxia on cancer therapeutics is significant: hypoxic tissue is 3× less radiosensitive than normoxic tissue, the impaired blood flow found in hypoxic tumor regions influences chemotherapy delivery, and the immune system is dependent on oxygen for functionality. Despite the clinical implications of hypoxia, there is not a universal, ideal method for quantifying hypoxia, particularly cycling hypoxia because of its complexity and heterogeneity across tumor types and individuals. Most standard imaging techniques can be modified and applied to measuring hypoxia and quantifying its effects; however, the benefits and challenges of each imaging modality makes imaging hypoxia case-dependent. In this chapter, a comprehensive overview of the preclinical and clinical methods for quantifying hypoxia is presented along with the advantages and disadvantages of each.
Collapse
|
19
|
Prognostic Value of Tumor Heterogeneity on 18F-FDG PET/CT in HR+HER2- Metastatic Breast Cancer Patients receiving 500 mg Fulvestrant: a retrospective study. Sci Rep 2018; 8:14458. [PMID: 30262849 PMCID: PMC6160449 DOI: 10.1038/s41598-018-32745-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 07/20/2018] [Indexed: 02/01/2023] Open
Abstract
Heterogeneity has been demonstrated to be a predictor of treatment failure and drug resistance. Our study aimed to investigate imaging parameters, including tumor heterogeneity, as prognostic factors of response to 500 mg fulvestrant using 18F-FDG PET/CT. Twenty-seven estrogen receptor (HR)-positive/HER2-negative metastatic breast cancer patients who received 500 mg fulvestrant and underwent 18F-FDG PET/CT before treatment were retrospectively included. In PET/CT scans, conventional parameters (maximum and mean standardized uptake value, metabolic tumor volume [MTV], total lesion glycolysis [TLG]) and heterogeneity parameters (intra-tumor heterogeneity index [HI] and inter-tumor heterogeneity coefficient of variation [COV]) were analyzed. Progression-free survival (PFS) was mainly assessed for efficacy. The survival analyses were performed using the Kaplan-Meier method. Univariate and multivariate analysis were performed using the Cox proportional hazard model. Univariate analysis indicated that a high SUVmax and a high tumor HI at baseline were associated with longer PFS of fulvestrant (P = 0.036 and P = 0.033, respectively). Liver metastasis, SUVmax and HI were statistically significant in multivariate analysis (P values of 0.017, 0.025 and 0.043, respectively). 18F-FDG based intra-tumor heterogeneity appears to be a potential predicator of efficacy of fulvestrant among HR+HER2- metastatic breast cancer patients.
Collapse
|
20
|
Abstract
After an overview of the principles of fludeoxyglucose-PET/computed tomography (CT) in breast cancer, its advantages and limits to evaluate treatment response are discussed. The metabolic information is helpful for early assessment of the response to neoadjuvant chemotherapy and could be used to monitor treatment, especially in aggressive breast cancer subtypes. PET/CT is also a powerful method for early assessment of the treatment response in the metastatic setting. It allows evaluation of different sites of metastases in a single examination and detection of a heterogeneous response. However, to use PET/CT to assess responses, methodology for image acquisition and analysis needs standardization.
Collapse
Affiliation(s)
- David Groheux
- Department of Nuclear Medicine, Saint-Louis Hospital, 1 Avenue Claude Vellefaux, Paris 75475 Cedex 10, France.
| |
Collapse
|
21
|
Humbert O, Lasserre M, Bertaut A, Fumoleau P, Coutant C, Brunotte F, Cochet A. Breast Cancer Blood Flow and Metabolism on Dual-Acquisition 18F-FDG PET: Correlation with Tumor Phenotype and Neoadjuvant Chemotherapy Response. J Nucl Med 2018; 59:1035-1041. [DOI: 10.2967/jnumed.117.203075] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 01/04/2018] [Indexed: 11/16/2022] Open
|
22
|
Humbert O, Riedinger JM, Chardin D, Desmoulins I, Brunotte F, Cochet A. SUV calculation in breast cancer: which normalization should be applied when using 18F-FDG PET? THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF RADIOPHARMACEUTICAL CHEMISTRY AND BIOLOGY 2018; 63:399-407. [PMID: 29345443 DOI: 10.23736/s1824-4785.18.03006-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND When using 18F-FDG PET, glucose metabolism quantification is affected by various factors. We aimed to investigate the benefit of different standardized uptake value (SUV) normalizations to improve the accuracy of 18F-FDG uptake to predict breast cancer aggressiveness and response to treatment. METHODS Two hundred fifty-two women with locally advanced breast cancer treated with neoadjuvant chemotherapy (NAC) were included. Women underwent 18F-FDG PET before and after the first course of NAC. Glucose serum levels, patient heights and weights were recorded at the time of each PET exam. Four different procedures for SUV normalization of the primary tumor were used: by body weight (SUVBW) by blood glucose level (SUVG), by lean body mass (SUL) and then corrected for both lean body mass and blood glucose level (SULG). RESULTS At baseline, SUL was significantly lower than SUVBW (5.9±4.0 and 9.5±6.5, respectively; P<0.0001), whereas SUVG and SUVBW were not significantly different (9.7±6.4 and 9.5±6.5, respectively; P=0.67). Concerning SUV changes (ΔSUV), the different normalizations methods did not induce significant quantitative differences. The correlation coefficients were high between the four normalizations methods of SUV1, SUV2 and ΔSUVB (R>0.95; P<0.0001). High baseline SUVBW measures were positively correlated with the biological tumor characteristics of aggressiveness and proliferation (P<0.001): ductal carcinoma, high tumor grading, high mitotic activity, negative estrogen receptor status and the TNBC subtype. ΔSUVBW was highly predictive of pCR (AUC=0.76 on ROC curve analysis; P<0.0001). The different SUV normalizations yields identical statistical results and AUC to predict tumor biological aggressiveness and response to therapy. CONCLUSIONS In the present setting, SUVBW and SUL can be considered as robust measures and be used in future multicenter trials. The additional normalization of SUV by glycemia involves stringent methodologic procedures to avoid biased risk measurements and offers no statistical advantages.
Collapse
Affiliation(s)
- Olivier Humbert
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, University of Côte d'Azur, Nice, France - .,TIRO-UMR E 4320, University of Nice-Sophia-Antipolis, Nice, France -
| | - Jean-Marc Riedinger
- Department of Nuclear Medicine, Centre G.F. Leclerc, Dijon, France.,Departments of Biology and Pathology, Centre G.F. Leclerc, Dijon, France
| | - David Chardin
- Department of Nuclear Medicine, Centre Antoine-Lacassagne, University of Côte d'Azur, Nice, France
| | | | - François Brunotte
- Department of Nuclear Medicine, Centre G.F. Leclerc, Dijon, France.,Department of Imaging, Le Bocage University Hospital, Dijon, France.,Le2i FRE2005, The National Center for Scientific Research (CNRS), University of Bourgogne Franche-Comté, Dijon, France
| | - Alexandre Cochet
- Department of Nuclear Medicine, Centre G.F. Leclerc, Dijon, France.,Department of Imaging, Le Bocage University Hospital, Dijon, France.,Le2i FRE2005, The National Center for Scientific Research (CNRS), University of Bourgogne Franche-Comté, Dijon, France
| |
Collapse
|
23
|
Dynamic 2-Deoxy-2-[ 18F]Fluoro-D-Glucose Positron Emission Tomography for Chemotherapy Response Monitoring of Breast Cancer Xenografts. Mol Imaging Biol 2017; 19:271-279. [PMID: 27541026 DOI: 10.1007/s11307-016-0998-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Non-invasive response monitoring can potentially be used to guide therapy selection for breast cancer patients. We employed dynamic 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography ([18F]FDG PET) to evaluate changes in three breast cancer xenograft lines in mice following three chemotherapy regimens. PROCEDURES Sixty-six athymic nude mice bearing bilateral breast cancer xenografts (two basal-like and one luminal-like subtype) underwent three 60 min [18F]FDG PET scans. Scans were performed prior to and 3 and 10 days after treatment with doxorubicin, paclitaxel, or carboplatin. Tumor growth was monitored in parallel. A pharmacokinetic compartmental model was fitted to the tumor uptake curves, providing estimates of transfer rates between the vascular, non-metabolized, and metabolized compartments. Early and late standardized uptake values (SUVE and SUVL, respectively); the rate constants k 1, k 2, and k 3, and the intravascular fraction v B were estimated. Changes in tumor volume were used as a response measure. Multivariate partial least-squares regression (PLSR) was used to assess if PET parameters could model tumor response and to identify PET parameters with the largest impact on response. RESULTS Treatment responders had significantly larger perfusion-related parameters (k 1 and k 2) and lower metabolism-related parameter (k 3) than non-responders 10 days after the start of treatment. These findings were further supported by the PLSR analysis, which showed that k 1 and k 2 at day 10 and changes in k 3 explained most of the variability in response to therapy, whereas SUVL and particularly SUVE were of lesser importance. CONCLUSIONS Overall, rate parameters related to both tumor perfusion and metabolism were associated with tumor response. Conventional metrics of [18F]FDG uptake such as SUVE and SUVL apparently had little relation to tumor response, thus necessitating full dynamic scanning and pharmacokinetic analysis for optimal evaluation of chemotherapy-induced changes in breast cancers.
Collapse
|
24
|
Chen S, Ibrahim NK, Yan Y, Wong ST, Wang H, Wong FC. Complete Metabolic Response on Interim 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography to Predict Long-Term Survival in Patients with Breast Cancer Undergoing Neoadjuvant Chemotherapy. Oncologist 2017; 22:526-534. [PMID: 28377466 DOI: 10.1634/theoncologist.2016-0334] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 01/05/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND This study aims to investigate the prognostic role of complete metabolic response (CMR) on interim 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) in patients with breast cancer (BC) receiving neoadjuvant chemotherapy (NAC) according to tumor subtypes and PET timing. PATIENTS AND METHODS Eighty-six consecutive patients with stage II/III BC who received PET/CT during or following NAC were included. Time-dependent receiver operating characteristic analysis and Kaplan-Meier analysis were used to determine correlation between metabolic parameters and survival outcomes. RESULTS The median follow-up duration was 71 months. Maximum standardized uptake value (SUVmax) on an interim PET/CT independently correlated with survival by multivariate analysis (overall survival [OS]: hazard ratio: 1.139, 95% confidence interval: 1.058-1.226, p = .001). By taking PET timing into account, best association of SUVmax with survival was obtained on PET after two to three cycles of NAC (area under the curve [AUC]: 0.941 at 1 year after initiation of NAC) and PET after four to five (AUC: 0.871 at 4 years), while PET after six to eight cycles of NAC had less prognostic value. CMR was obtained in 62% of patients (23/37) with estrogen receptor-positive (ER+)/human epidermal growth factor receptor 2-negative (HER2-) BC, in 48% (12/25) triple-negative BC (TNBC), and in 75% (18/24) HER2-positive (HER2+) tumors. Patients with CMR on an early-mid PET had 5-year OS rates of 92% for ER+/HER2- tumors and 80% for TNBC, respectively. Among HER2+ subtype, 89% patients (16/18) with CMR had no relapse. CONCLUSION CMR indicated a significantly better outcome in BC and may serve as a favorable imaging prognosticator. The Oncologist 2017;22:526-534 IMPLICATIONS FOR PRACTICE: This study shows a significantly better outcome for breast cancer (BC) patients who achieved complete metabolic response (CMR) on 18F-fluorodeoxyglucose emission tomography/computed tomography (PET/CT) during neoadjuvant chemotherapy, especially for hormone receptor-positive tumors and triple negative BC. Moreover, PET/CT performed during an early- or mid-course neoadjuvant therapy is more predictive for long-term survival outcome than a late PET/CT. These findings support that CMR may serve as a favorable imaging prognosticator for BC and has potential for application to daily clinical practice.
Collapse
Affiliation(s)
- Suyun Chen
- Department of Nuclear Medicine, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Nuhad K Ibrahim
- Department of Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Yuanqing Yan
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Stephen T Wong
- Department of System Medicine and Bioengineering, Methodist Hospital Research Institution, Weill Cornell Medical College, Houston, Texas, USA
| | - Hui Wang
- Department of Nuclear Medicine, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Franklin C Wong
- Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
25
|
Is (18)FDG uptake useful to decide on chemotherapy in ER+/HER2- breast cancer? Eur J Nucl Med Mol Imaging 2017; 43:1571-3. [PMID: 27245758 DOI: 10.1007/s00259-016-3430-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
26
|
Imaging performance in guiding response to neoadjuvant therapy according to breast cancer subtypes: A systematic literature review. Crit Rev Oncol Hematol 2017; 112:198-207. [PMID: 28325260 DOI: 10.1016/j.critrevonc.2017.02.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 01/18/2017] [Accepted: 02/14/2017] [Indexed: 11/23/2022] Open
Abstract
Monitoring therapeutic response to neoadjuvant chemotherapy(NAC) is likely to improve NAC effectiveness in breast cancer(BC). Imaging performance seems to vary per tumour subtype(by ER and HER2 status), therefore we performed a systematic review on subtype specific imaging performance in monitoring NAC in BC. Studies examining imaging performance in predicting pathologic complete response(pCR) during NAC in BC subtypes were selected. Per study, negative- and positive predictive value, sensitivity(se) and specificity(sp), AUC and accuracy were derived. Fifteen/106 articles were included. Inter-study variability was revealed in: monitoring interval, response and pCR definitions. In ER-positive/HER2-negative BC, 181F FDG-PET/CT showed se/sp of 38%-89%/74%-100%, MRI showed se/sp of 35%-37%/87%-89%. In triple negative BC, 181F FDG-PET/CT showed se/sp of 0%-79%/95%-100%. 181F FDG-PET/CT showed in ER-positive/HER2-positive BC se/sp of 59%/80% and in ER-negative/HER2-positive 27%/88%. Evidence on imaging performance in monitoring NAC according BC subtypes is lacking. Consensus should be reached in: definitions of pCR, response and monitoring interval before starting well-designed studies.
Collapse
|
27
|
Correlation between tumour characteristics, SUV measurements, metabolic tumour volume, TLG and textural features assessed with 18F-FDG PET in a large cohort of oestrogen receptor-positive breast cancer patients. Eur J Nucl Med Mol Imaging 2017; 44:1145-1154. [PMID: 28188325 DOI: 10.1007/s00259-017-3641-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 01/26/2017] [Indexed: 02/08/2023]
Abstract
PURPOSE The study was designed to evaluate 1) the relationship between PET image textural features (TFs) and SUVs, metabolic tumour volume (MTV), total lesion glycolysis (TLG) and tumour characteristics in a large prospective and homogenous cohort of oestrogen receptor-positive (ER+) breast cancer (BC) patients, and 2) the capability of those parameters to predict response to neoadjuvant chemotherapy (NAC). METHODS 171 consecutive patients with large or locally advanced ER+ BC without distant metastases underwent an 18F-FDG PET examination before NAC. The primary tumour was delineated with an adaptive threshold segmentation method. Parameters of volume, intensity and texture (entropy, homogeneity, contrast and energy) were measured and compared with tumour characteristics determined on pre-treatment breast biopsy (Wilcoxon rank-sum test). The correlation between PET-derived parameters was determined using Spearman's coefficient. The relationship between PET features and pathological findings was determined using the Wilcoxon rank-sum test. RESULTS Spearman's coefficients between SUVmax and TFs were 0.43, 0.24, -0.43 and -0.15 respectively for entropy, homogeneity, energy and contrast; they were higher between MTV and TFs: 0.99, 0.86, -0.99 and -0.87. All TFs showed a significant association with the histological type (IDC vs. ILC; 0.02 < P < 0.03) but didn't with immunohistochemical characteristics. SUVmax and TLG predicted the pathological response (P = 0.0021 and P = 0.02 respectively); TFs didn't (P: 0.27, 0.19, 0.94, 0.19 respectively for entropy, homogeneity, energy and contrast). CONCLUSIONS The correlation of TFs was poor with SUV parameters and high with MTV. TFs showed a significant association with the histological type. Finally, while SUVmax and TLG were able to predict response to NAC, TFs failed.
Collapse
|
28
|
Groheux D, Martineau A, Teixeira L, Espié M, de Cremoux P, Bertheau P, Merlet P, Lemarignier C. 18FDG-PET/CT for predicting the outcome in ER+/HER2- breast cancer patients: comparison of clinicopathological parameters and PET image-derived indices including tumor texture analysis. Breast Cancer Res 2017; 19:3. [PMID: 28057031 PMCID: PMC5217422 DOI: 10.1186/s13058-016-0793-2] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 12/06/2016] [Indexed: 12/21/2022] Open
Abstract
Background This study investigated the value of some clinicopathological parameters and 18 F-fluorodeoxyglucose-positron emission tomography/computed tomography (18FDG-PET/CT) indices, including textural features, to predict event-free survival (EFS) in estrogen receptor-positive/human epidermal growth factor receptor 2-negative (ER+/HER2-) locally advanced breast cancer (BC) patients. Methods FDG-PET/CT indices and clinicopathological parameters were assessed before neoadjuvant chemotherapy (NAC). After completion of chemotherapy, all patients had breast surgery with axillary lymph node dissection, followed by radiation therapy and endocrine therapy for 5 years. EFS was estimated using the Kaplan-Meier method. A Cox proportional hazard regression model was used for multivariate analysis. Results One hundred forty-three consecutive patients with stage II–III ER+/HER2- BC and without distant metastases at baseline PET were included. High standardized uptake values (SUVs), were associated with shorter EFS (HR = 3.51, P < 0.01 for SUVmax; HR = 2.76, P = 0.02 for SUVmean; and HR = 4.40 P < 0.01 for SUVpeak). Metabolically active tumor volume (MATV, HR = 3.47, P < 0.01) and total lesion glycolysis (TLG, HR = 3.10, P < 0.01) were also predictive of EFS. Homogeneity was not predictive (HR = 2.27, P = 0.07) and entropy had weak prediction (HR = 2.89, P = 0.02). Among clinicopathological parameters, EFS was shorter in progesterone receptor (PR)-negative tumor (vs. PR-positive tumor; HR = 3.25, P < 0.01); histology was predictive of EFS (lobular vs. ductal invasive carcinoma; HR = 3.74, P = 0.01) but not tumor grade (grade 3 vs. grade 1–2; HR = 1.64, P = 0.32). Pathological complete response after NAC was not correlated to the risk of relapse. Three parameters remained significantly associated with EFS in multivariate analysis. MATV (HR = 1.01, P < 0.01), progesterone receptor expression (HR = 2.90, P = 0.03) and tumor histology (HR = 3.80, P = 0.02). Conclusions Baseline PET parameters measured before neoadjuvant treatment have prognostic values in ER+/HER2- locally advanced breast cancer patients. After multivariate analysis, metabolically active tumor volume remains significant while textural analysis of PET images is not of added value. Considering histopathological parameters, our study shows that patients with PR-negative or lobular invasive tumor have poorer prognosis than patients with PR-positive or ductal carcinoma, respectively.
Collapse
Affiliation(s)
- David Groheux
- Department of Nuclear Medicine, Saint-Louis Hospital, Paris, France. .,University Paris-Diderot, INSERM/CNRS UMR944/7212, Paris, France.
| | | | - Luis Teixeira
- University Paris-Diderot, INSERM/CNRS UMR944/7212, Paris, France.,Breast Diseases Unit, Saint-Louis Hospital, Paris, France
| | - Marc Espié
- University Paris-Diderot, INSERM/CNRS UMR944/7212, Paris, France.,Breast Diseases Unit, Saint-Louis Hospital, Paris, France
| | - Patricia de Cremoux
- University Paris-Diderot, INSERM/CNRS UMR944/7212, Paris, France.,Department of Biochemistry, Saint-Louis Hospital, Paris, France
| | | | - Pascal Merlet
- Department of Nuclear Medicine, Saint-Louis Hospital, Paris, France
| | - Charles Lemarignier
- Department of Nuclear Medicine, Saint-Louis Hospital, Paris, France.,University Paris-Diderot, INSERM/CNRS UMR944/7212, Paris, France
| |
Collapse
|
29
|
Prognostic Role of Early and End-of-Neoadjuvant Treatment 18F-FDG PET/CT in Patients With Breast Cancer. Clin Nucl Med 2016; 41:e313-22. [DOI: 10.1097/rlu.0000000000001191] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
30
|
Avril S, Muzic RF, Plecha D, Traughber BJ, Vinayak S, Avril N. ¹⁸F-FDG PET/CT for Monitoring of Treatment Response in Breast Cancer. J Nucl Med 2016; 57 Suppl 1:34S-9S. [PMID: 26834099 DOI: 10.2967/jnumed.115.157875] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Changes in tumor metabolic activity have been shown to be an early indicator of treatment effectiveness for breast cancer, mainly in the neoadjuvant setting. The histopathologic response at the completion of chemotherapy has been used as the reference standard for assessment of the accuracy of (18)F-FDG PET in predicting a response during systemic treatment. Although a pathologic complete response (pCR) remains an important positive prognostic factor for an individual patient, a recent metaanalysis could validate pCR as a surrogate marker for patient outcomes only in aggressive breast cancer subtypes. For establishment of the clinical application of metabolic treatment response studies, larger series of specific breast cancer subtypes-including hormone receptor-positive, human epidermal growth factor receptor 2-positive, and triple-negative breast cancers-are necessary. In addition, thresholds for relative changes in (18)F-FDG uptake to distinguish between responding and nonresponding tumors need to be validated for different systemic treatment approaches, with progression-free survival and overall survival as references. A PET-based treatment stratification is applicable clinically only if valid alternative therapies are available. Of note, patients who do not achieve a pCR might still benefit from neoadjuvant therapy enabling breast-conserving surgery. In the metastatic setting, residual tumor metabolic activity after the initiation of systemic therapy is an indicator of active disease, whereas a complete resolution of metabolic activity is predictive of a successful treatment response.
Collapse
Affiliation(s)
- Stefanie Avril
- Department of Pathology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Raymond F Muzic
- Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Donna Plecha
- Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Bryan J Traughber
- Department of Radiation Oncology, Seidman Cancer Center, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio; and
| | - Shaveta Vinayak
- Department of Medicine (Hematology and Oncology), Seidman Cancer Center, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Norbert Avril
- Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio
| |
Collapse
|
31
|
Lee HW, Lee HM, Choi SE, Yoo H, Ahn SG, Lee MK, Jeong J, Jung WH. The Prognostic Impact of Early Change in 18F-FDG PET SUV After Neoadjuvant Chemotherapy in Patients with Locally Advanced Breast Cancer. J Nucl Med 2016; 57:1183-8. [DOI: 10.2967/jnumed.115.166322] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 03/08/2016] [Indexed: 01/28/2023] Open
|
32
|
Abstract
Breast cancer is the most common malignancy in females. Imaging plays a critical role in diagnosis, staging and surveillance, and management of disease. Fluorodeoxyglucose (FDG) PET the imaging is indicated in specific clinical setting. Sensitivity of detection depends on tumor histology and size. Whole body FDG PET can change staging and management. In recurrent disease, distant metastasis can be detected. FDG PET imaging has prognostic and predictive value. PET/MR is evolving rapidly and may play a role management, assessment of metastatic lesions, and treatment monitoring. This review discusses current PET modalities, focusing on of FDG PET imaging and novel tracers.
Collapse
Affiliation(s)
- Lizza Lebron
- Molecular Imaging and Therapy Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Daniel Greenspan
- Molecular Imaging and Therapy Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Neeta Pandit-Taskar
- Molecular Imaging and Therapy Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
| |
Collapse
|
33
|
18F-FDG PET/CT in the early prediction of pathological response in aggressive subtypes of breast cancer: review of the literature and recommendations for use in clinical trials. Eur J Nucl Med Mol Imaging 2016; 43:983-993. [DOI: 10.1007/s00259-015-3295-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 12/21/2015] [Indexed: 10/22/2022]
|
34
|
Kitajima K, Miyoshi Y. Present and future role of FDG-PET/CT imaging in the management of breast cancer. Jpn J Radiol 2016; 34:167-80. [DOI: 10.1007/s11604-015-0516-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 12/20/2015] [Indexed: 02/08/2023]
|
35
|
Xu C, Vavadi H, Merkulov A, Li H, Erfanzadeh M, Mostafa A, Gong Y, Salehi H, Tannenbaum S, Zhu Q. Ultrasound-Guided Diffuse Optical Tomography for Predicting and Monitoring Neoadjuvant Chemotherapy of Breast Cancers: Recent Progress. ULTRASONIC IMAGING 2016; 38:5-18. [PMID: 25887527 PMCID: PMC5056904 DOI: 10.1177/0161734615580280] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
In this manuscript, we review the current progress of utilizing ultrasound-guided diffuse optical tomography (US-guided DOT) for predicting and monitoring neoadjuvant chemotherapy (NAC) outcomes of breast cancer patients. We also report the recent advance on optical tomography systems toward portable and robust clinical use at multiple clinical sites. The first patient who has been closely monitored before NAC, at day 2, day 8, end of first three cycles of NAC, and before surgery is given as an example to demonstrate the potential of US-guided DOT technique.
Collapse
Affiliation(s)
- Chen Xu
- Department of Electrical and Computer Engineering, University of Connecticut, Storrs, CT, USA Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA
| | - Hamed Vavadi
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA
| | - Alex Merkulov
- University of Connecticut Health Center, Farmington, CT, USA
| | - Hai Li
- Department of Electrical and Computer Engineering, University of Connecticut, Storrs, CT, USA
| | - Mohsen Erfanzadeh
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA
| | - Atahar Mostafa
- Department of Electrical and Computer Engineering, University of Connecticut, Storrs, CT, USA
| | - Yanping Gong
- Department of Electrical and Computer Engineering, University of Connecticut, Storrs, CT, USA
| | - Hassan Salehi
- Department of Electrical and Computer Engineering, University of Connecticut, Storrs, CT, USA
| | | | - Quing Zhu
- Department of Electrical and Computer Engineering, University of Connecticut, Storrs, CT, USA Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA
| |
Collapse
|
36
|
Xu C, Vavadi H, Merkulov A, Li H, Erfanzadeh M, Mostafa A, Gong Y, Salehi H, Tannenbaum S, Zhu Q. Ultrasound-Guided Diffuse Optical Tomography for Predicting and Monitoring Neoadjuvant Chemotherapy of Breast Cancers: Recent Progress. ULTRASONIC IMAGING 2016. [PMID: 25887527 DOI: 10.1177/016173461558028010.1177/0161734615580280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
In this manuscript, we review the current progress of utilizing ultrasound-guided diffuse optical tomography (US-guided DOT) for predicting and monitoring neoadjuvant chemotherapy (NAC) outcomes of breast cancer patients. We also report the recent advance on optical tomography systems toward portable and robust clinical use at multiple clinical sites. The first patient who has been closely monitored before NAC, at day 2, day 8, end of first three cycles of NAC, and before surgery is given as an example to demonstrate the potential of US-guided DOT technique.
Collapse
Affiliation(s)
- Chen Xu
- Department of Electrical and Computer Engineering, University of Connecticut, Storrs, CT, USA Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA
| | - Hamed Vavadi
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA
| | - Alex Merkulov
- University of Connecticut Health Center, Farmington, CT, USA
| | - Hai Li
- Department of Electrical and Computer Engineering, University of Connecticut, Storrs, CT, USA
| | - Mohsen Erfanzadeh
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA
| | - Atahar Mostafa
- Department of Electrical and Computer Engineering, University of Connecticut, Storrs, CT, USA
| | - Yanping Gong
- Department of Electrical and Computer Engineering, University of Connecticut, Storrs, CT, USA
| | - Hassan Salehi
- Department of Electrical and Computer Engineering, University of Connecticut, Storrs, CT, USA
| | | | - Quing Zhu
- Department of Electrical and Computer Engineering, University of Connecticut, Storrs, CT, USA Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA
| |
Collapse
|
37
|
Concerning pretreatment ¹⁸F-FDG PET/CT imaging in patients with large or locally advanced breast cancer. Eur J Nucl Med Mol Imaging 2015; 42:1801-3. [PMID: 26239284 DOI: 10.1007/s00259-015-3144-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Accepted: 07/12/2015] [Indexed: 10/23/2022]
|
38
|
García Vicente AM, Soriano Castrejón Á, López-Fidalgo JF, Amo-Salas M, Muñoz Sanchez MDM, Álvarez Cabellos R, Espinosa Aunión R. Basal 18 F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography as a prognostic biomarker in patients with locally advanced breast cancer. Eur J Nucl Med Mol Imaging 2015; 42:1804-13. [DOI: 10.1007/s00259-015-3102-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 05/28/2015] [Indexed: 01/19/2023]
|
39
|
Do clinical, histological or immunohistochemical primary tumour characteristics translate into different (18)F-FDG PET/CT volumetric and heterogeneity features in stage II/III breast cancer? Eur J Nucl Med Mol Imaging 2015; 42:1682-1691. [PMID: 26140849 DOI: 10.1007/s00259-015-3110-x] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 06/03/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE The aim of this retrospective study was to determine if some features of baseline (18)F-FDG PET images, including volume and heterogeneity, reflect clinical, histological or immunohistochemical characteristics in patients with stage II or III breast cancer (BC). METHODS Included in the present retrospective analysis were 171 prospectively recruited patients with stage II/III BC treated consecutively at Saint-Louis hospital. Primary tumour volumes were semiautomatically delineated on pretreatment (18)F-FDG PET images. The parameters extracted included SUVmax, SUVmean, metabolically active tumour volume (MATV), total lesion glycolysis (TLG) and heterogeneity quantified using the area under the curve of the cumulative histogram and textural features. Associations between clinical/histopathological characteristics and (18)F-FDG PET features were assessed using one-way analysis of variance. Areas under the ROC curves (AUC) were used to quantify the discriminative power of the features significantly associated with clinical/histopathological characteristics. RESULTS T3 tumours (>5 cm) exhibited higher textural heterogeneity in (18)F-FDG uptake than T2 tumours (AUC <0.75), whereas there were no significant differences in SUVmax and SUVmean. Invasive ductal carcinoma showed higher SUVmax values than invasive lobular carcinoma (p = 0.008) but MATV, TLG and textural features were not discriminative. Grade 3 tumours had higher FDG uptake (AUC 0.779 for SUVmax and 0.694 for TLG), and exhibited slightly higher regional heterogeneity (AUC 0.624). Hormone receptor-negative tumours had higher SUV values than oestrogen receptor-positive (ER-positive) and progesterone receptor-positive tumours, while heterogeneity patterns showed only low-level variation according to hormone receptor expression. HER-2 status was not associated with any of the image features. Finally, SUVmax, SUVmean and TLG significantly differed among the three phenotype subgroups (HER2-positive, triple-negative and ER-positive/HER2-negative BCs), but MATV and heterogeneity metrics were not discriminative. CONCLUSION SUV parameters, MATV and textural features showed limited correlations with clinical and histopathological features. The three main BC subgroups differed in terms of SUVs and TLG but not in terms of MATV and heterogeneity. None of the PET-derived metrics offered high discriminative power.
Collapse
|
40
|
Deng SM, Zhang W, Zhang B, Chen YY, Li JH, Wu YW. Correlation between the Uptake of 18F-Fluorodeoxyglucose (18F-FDG) and the Expression of Proliferation-Associated Antigen Ki-67 in Cancer Patients: A Meta-Analysis. PLoS One 2015; 10:e0129028. [PMID: 26038827 PMCID: PMC4454667 DOI: 10.1371/journal.pone.0129028] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 05/04/2015] [Indexed: 12/22/2022] Open
Abstract
Objective To study the correlation between 18F-FDG uptake and cell proliferation in cancer patients by meta-analysis of published articles. Methods We searched PubMed (MEDLINE included), EMBASE, and Cochrane Database of Systematic Review, and selected research articles on the relationship between 18F-FDG uptake and Ki-67 expression (published between August 1, 1994-August 1, 2014), according to the literature inclusion and exclusion criteria. The publishing language was limited to English. The quality of included articles was evaluated according to the Quality Assessment of Diagnosis Accuracy Studies-2 (QUADAS-2). The correlation coefficient (r) was extracted from the included articles and processed by Fisher's r-to-z transformation. The combined correlation coefficient (r) and the 95% confidence interval (CI) were calculated with STATA 11.0 software under a random-effects model. Begg's test was used to analyze the existence of publication bias and draw funnel plot, and the sources of heterogeneity were explored by sensitivity and subgroup analyses. Results According to the inclusion and exclusion criteria, 79 articles were finally included, including 81 studies involving a total of 3242 patients. All the studies had a combined r of 0.44 (95% CI, 0.41-0.46), but with a significant heterogeneity (I2 = 80.9%, P<0.01). Subgroup analysis for different tumor types indicated that most subgroups showed a reduced heterogeneity. Malignant melanoma (n = 1) had the minimum correlation coefficient (-0.22) between 18F-FDG uptake and Ki-67 expression, while the thymic epithelial tumors (TETs; n = 2) showed the maximum correlation coefficient of 0.81. The analytical results confirmed that correlation between 18F-FDG uptake and Ki-67 expression was extremely significant in TETs, significant in gastrointestinal stromal tumors (GISTs), moderate in patients with lung, breast, bone and soft tissue, pancreatic, oral, thoracic, and uterine and ovarian cancers, average in brain, esophageal and colorectal cancers, and poor in head and neck, thyroid, gastric and malignant melanoma tumors. Subgroup analysis indicated that positron emission tomography (PET) or PET/CT imaging technology or Ki-67 and standardized uptake value (SUV) measurement technology did not significantly affect the results of r values, and Begg's test showed no significant publication bias. Conclusion In cancer patients, 18F-FDG uptake showed a moderate positive correlation with tumor cell proliferation. Different tumor types exhibited varied degree of correlation, and the correlation was significant in TETs and GSTs. However, our results need further validation by clinical trials with a large sample of different tumor types.
Collapse
Affiliation(s)
- Sheng-ming Deng
- Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
- School of Radiation Medicine and Protection, Medical College of Soochow University, Suzhou, China
| | - Wei Zhang
- Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Bin Zhang
- Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
- Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, China
- * E-mail:
| | - Yin-yin Chen
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Ji-hui Li
- Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yi-wei Wu
- Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| |
Collapse
|
41
|
Shimada H, Ueda S, Saeki T, Shigekawa T, Takeuchi H, Hirokawa E, Sugitani I, Sugiyama M, Takahashi T, Matsuura K, Yamane T, Kuji I, Hasebe T, Osaki A. Neoadjuvant triweekly nanoparticle albumin-bound paclitaxel followed by epirubicin and cyclophosphamide for Stage II/III HER2-negative breast cancer: evaluation of efficacy and safety. Jpn J Clin Oncol 2015; 45:642-9. [PMID: 25989989 DOI: 10.1093/jjco/hyv055] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 03/25/2015] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE Nanoparticle albumin-bound paclitaxel (nab-PTX) is a solvent-free paclitaxel coupled to human albumin without an associated increase in toxicity. The neoadjuvant study of primary breast cancer was planned to evaluate tumor response and safety of triweekly nanoparticle albumin-bound paclitaxel. METHODS Patients with Stage II/III HER2-negative primary breast cancer received four courses of nanoparticle albumin-bound paclitaxel 260 mg/m(2) every 3 weeks (q3w), followed by four courses of epirubicin 90 mg/m(2) plus cyclophosphamide 600 mg/m(2) q3w. Tumor response after nanoparticle albumin-bound paclitaxel was histologically evaluated. In addition, the clinical response, breast-conserving rate and safety of this treatment were monitored. RESULTS Among 53 patients who received nanoparticle albumin-bound paclitaxel followed by epirubicin and cyclophosphamide neoadjuvant chemotherapy, pathological complete response and near-pathological complete response were confirmed in 3 (5.7%) and 7 (13.2%) patients who had surgery, respectively. The overall objective response rate was 71.7% after completion of chemotherapy. Based on Positron Emission Tomography Response Criteria in Solid Tumors using (18)F-fluorodeoxyglucose, complete metabolic response and partial metabolic response after 2-3 courses of nanoparticle albumin-bound paclitaxel were 15.1 and 52.8%, respectively. The most common significant toxicities of q3w nanoparticle albumin-bound paclitaxel were Grade 3 muscle pain, neuropathy and febrile neutropenia, each in 1 (1.9%) patient. There were no incidences of anaphylaxis or Grade 4/5 adverse events. CONCLUSION Neoadjuvant chemotherapy using q3w nanoparticle albumin-bound paclitaxel followed by epirubicin and cyclophosphamide was feasible in breast cancer patients with acceptable clinical response and drug tolerance, but conferred a low rate of pathological complete response. Monotherapy with q3w nanoparticle albumin-bound paclitaxel could be an appropriate substitute for solvent-based taxane in terms of therapeutic and safety management.
Collapse
Affiliation(s)
- Hiroko Shimada
- Department of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka, Saitama
| | - Shigeto Ueda
- Department of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka, Saitama
| | - Toshiaki Saeki
- Department of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka, Saitama
| | - Takashi Shigekawa
- Department of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka, Saitama
| | - Hideki Takeuchi
- Department of Breast Oncology, Saitama Medical University, Iruma, Saitama
| | - Eiko Hirokawa
- Department of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka, Saitama
| | - Ikuko Sugitani
- Department of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka, Saitama
| | - Michiko Sugiyama
- Department of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka, Saitama
| | - Takao Takahashi
- Department of Palliative Care, International Medical Center, Saitama Medical University, Hidaka, Saitama
| | - Kazuo Matsuura
- Department of Digestive and Breast Surgery, Hiroshima Prefectural Hospital, Hiroshima-shi, Hiroshima
| | - Tomohiko Yamane
- Department of Nuclear Medicine, International Medical Center, Saitama Medical University, Hidaka, Saitama
| | - Ichiei Kuji
- Department of Nuclear Medicine, International Medical Center, Saitama Medical University, Hidaka, Saitama
| | - Takahiro Hasebe
- Department of Pathology, International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan
| | - Akihiko Osaki
- Department of Breast Oncology, International Medical Center, Saitama Medical University, Hidaka, Saitama
| |
Collapse
|
42
|
Groheux D, Majdoub M, Sanna A, de Cremoux P, Hindié E, Giacchetti S, Martineau A, de Roquancourt A, Merlet P, Visvikis D, Resche-Rigon M, Hatt M, Espié M. Early Metabolic Response to Neoadjuvant Treatment: FDG PET/CT Criteria according to Breast Cancer Subtype. Radiology 2015; 277:358-71. [PMID: 25915099 DOI: 10.1148/radiol.2015141638] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE To investigate parameters based on fluorine 18 fluorodeoxyglucose (FDG) positron emission tomographic (PET) imaging that are best correlated with pathologic complete response (PCR) in human epidermal growth factor receptor type 2 (HER2)-positive cancer and triple-negative breast cancer (TNBC) and with partial or complete response in ER-positive/HER2-negative breast cancer. MATERIALS AND METHODS This study was approved by institutional review board with waivers of informed written consent and included consecutive patients treated by neoadjuvant chemotherapy. Five PET examination-derived parameters were tested: standard uptake value (SUV) maximum (SUV(max)), peak (SUV(peak)), and mean (SUV(mean)), metabolically active tumor volume, and total lesion glycolysis (TLG). Absolute values at baseline PET, at PET imaging after two cycles of chemotherapy, and variation (ie, change) were measured. Correlations with pathologic response (Wilcoxon rank-sum test) and predictive power assessed (area under the curve [AUC] on the basis of receiver operating characteristic analysis) were examined. RESULTS Included were 169 consecutive patients (mean age, 50 years). PCR was more frequent in HER2-positive tumors (16 of 33 patients [48.5%]) and TNBCs (20 of 54 patients [37%]) than in ER positive/HER2-negative tumors (four of 82 [4.9%]) (P < .001). Among patients with ER-positive/HER2-negative cancers, 33 patients had partial response. In TNBC, best association with PCR was obtained with change in SUV(max) (AUC, 0.86) or change in TLG (AUC, 0.88). In HER2-positive phenotype, absolute SUV(max) (or SUV(peak)) values at PET imaging after two cycles of chemotherapy (AUC for each cycle, 0.93) were better correlated with PCR than change in SUV(max) (AUC, 0.78; P = .11) or change in TLG (AUC, 0.62; P = .005). Regarding ER-positive/HER2-negative cancers, change in SUV(max) or change in TLG (AUC, 0.75) were parameters best correlated with partial or complete response. Baseline SUV(max) was higher in lymph nodes than in primary tumor in 31 patients. Findings were similar considering the site with highest FDG uptake. CONCLUSION Quantitative indexes of tumor glucose use that are best correlated with pathologic response vary by phenotype: change in SUV(max) or TLG are most adequate for TNBCs and ER-positive/ HER2-negative cancers and absolute SUV(max) after two cycles of chemotherapy for HER2-positive breast cancers.
Collapse
Affiliation(s)
- David Groheux
- From the Department of Nuclear Medicine (D.G., A.M., P.M.), Department of Statistical Sciences (A.S., M.R.R.), Department of Biochemistry (P.d.C.), Breast Diseases Unit and Department of Medical Oncology (S.G., M.E.), and Department of Pathology (A.d.R.), Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475 Paris Cedex 10, France; INSERM, UMR 1101 LaTIM, Brest, France (M.M., D.V., M.H.); Department of Nuclear Medicine, CHU Bordeaux, University of Bordeaux, Bordeaux, France (E.H.); and B2T, Doctoral School, IUH, University of Paris VII, Paris, France (D.G., P.M.)
| | - Mohamed Majdoub
- From the Department of Nuclear Medicine (D.G., A.M., P.M.), Department of Statistical Sciences (A.S., M.R.R.), Department of Biochemistry (P.d.C.), Breast Diseases Unit and Department of Medical Oncology (S.G., M.E.), and Department of Pathology (A.d.R.), Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475 Paris Cedex 10, France; INSERM, UMR 1101 LaTIM, Brest, France (M.M., D.V., M.H.); Department of Nuclear Medicine, CHU Bordeaux, University of Bordeaux, Bordeaux, France (E.H.); and B2T, Doctoral School, IUH, University of Paris VII, Paris, France (D.G., P.M.)
| | - Alice Sanna
- From the Department of Nuclear Medicine (D.G., A.M., P.M.), Department of Statistical Sciences (A.S., M.R.R.), Department of Biochemistry (P.d.C.), Breast Diseases Unit and Department of Medical Oncology (S.G., M.E.), and Department of Pathology (A.d.R.), Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475 Paris Cedex 10, France; INSERM, UMR 1101 LaTIM, Brest, France (M.M., D.V., M.H.); Department of Nuclear Medicine, CHU Bordeaux, University of Bordeaux, Bordeaux, France (E.H.); and B2T, Doctoral School, IUH, University of Paris VII, Paris, France (D.G., P.M.)
| | - Patricia de Cremoux
- From the Department of Nuclear Medicine (D.G., A.M., P.M.), Department of Statistical Sciences (A.S., M.R.R.), Department of Biochemistry (P.d.C.), Breast Diseases Unit and Department of Medical Oncology (S.G., M.E.), and Department of Pathology (A.d.R.), Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475 Paris Cedex 10, France; INSERM, UMR 1101 LaTIM, Brest, France (M.M., D.V., M.H.); Department of Nuclear Medicine, CHU Bordeaux, University of Bordeaux, Bordeaux, France (E.H.); and B2T, Doctoral School, IUH, University of Paris VII, Paris, France (D.G., P.M.)
| | - Elif Hindié
- From the Department of Nuclear Medicine (D.G., A.M., P.M.), Department of Statistical Sciences (A.S., M.R.R.), Department of Biochemistry (P.d.C.), Breast Diseases Unit and Department of Medical Oncology (S.G., M.E.), and Department of Pathology (A.d.R.), Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475 Paris Cedex 10, France; INSERM, UMR 1101 LaTIM, Brest, France (M.M., D.V., M.H.); Department of Nuclear Medicine, CHU Bordeaux, University of Bordeaux, Bordeaux, France (E.H.); and B2T, Doctoral School, IUH, University of Paris VII, Paris, France (D.G., P.M.)
| | - Sylvie Giacchetti
- From the Department of Nuclear Medicine (D.G., A.M., P.M.), Department of Statistical Sciences (A.S., M.R.R.), Department of Biochemistry (P.d.C.), Breast Diseases Unit and Department of Medical Oncology (S.G., M.E.), and Department of Pathology (A.d.R.), Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475 Paris Cedex 10, France; INSERM, UMR 1101 LaTIM, Brest, France (M.M., D.V., M.H.); Department of Nuclear Medicine, CHU Bordeaux, University of Bordeaux, Bordeaux, France (E.H.); and B2T, Doctoral School, IUH, University of Paris VII, Paris, France (D.G., P.M.)
| | - Antoine Martineau
- From the Department of Nuclear Medicine (D.G., A.M., P.M.), Department of Statistical Sciences (A.S., M.R.R.), Department of Biochemistry (P.d.C.), Breast Diseases Unit and Department of Medical Oncology (S.G., M.E.), and Department of Pathology (A.d.R.), Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475 Paris Cedex 10, France; INSERM, UMR 1101 LaTIM, Brest, France (M.M., D.V., M.H.); Department of Nuclear Medicine, CHU Bordeaux, University of Bordeaux, Bordeaux, France (E.H.); and B2T, Doctoral School, IUH, University of Paris VII, Paris, France (D.G., P.M.)
| | - Anne de Roquancourt
- From the Department of Nuclear Medicine (D.G., A.M., P.M.), Department of Statistical Sciences (A.S., M.R.R.), Department of Biochemistry (P.d.C.), Breast Diseases Unit and Department of Medical Oncology (S.G., M.E.), and Department of Pathology (A.d.R.), Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475 Paris Cedex 10, France; INSERM, UMR 1101 LaTIM, Brest, France (M.M., D.V., M.H.); Department of Nuclear Medicine, CHU Bordeaux, University of Bordeaux, Bordeaux, France (E.H.); and B2T, Doctoral School, IUH, University of Paris VII, Paris, France (D.G., P.M.)
| | - Pascal Merlet
- From the Department of Nuclear Medicine (D.G., A.M., P.M.), Department of Statistical Sciences (A.S., M.R.R.), Department of Biochemistry (P.d.C.), Breast Diseases Unit and Department of Medical Oncology (S.G., M.E.), and Department of Pathology (A.d.R.), Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475 Paris Cedex 10, France; INSERM, UMR 1101 LaTIM, Brest, France (M.M., D.V., M.H.); Department of Nuclear Medicine, CHU Bordeaux, University of Bordeaux, Bordeaux, France (E.H.); and B2T, Doctoral School, IUH, University of Paris VII, Paris, France (D.G., P.M.)
| | - Dimitris Visvikis
- From the Department of Nuclear Medicine (D.G., A.M., P.M.), Department of Statistical Sciences (A.S., M.R.R.), Department of Biochemistry (P.d.C.), Breast Diseases Unit and Department of Medical Oncology (S.G., M.E.), and Department of Pathology (A.d.R.), Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475 Paris Cedex 10, France; INSERM, UMR 1101 LaTIM, Brest, France (M.M., D.V., M.H.); Department of Nuclear Medicine, CHU Bordeaux, University of Bordeaux, Bordeaux, France (E.H.); and B2T, Doctoral School, IUH, University of Paris VII, Paris, France (D.G., P.M.)
| | - Matthieu Resche-Rigon
- From the Department of Nuclear Medicine (D.G., A.M., P.M.), Department of Statistical Sciences (A.S., M.R.R.), Department of Biochemistry (P.d.C.), Breast Diseases Unit and Department of Medical Oncology (S.G., M.E.), and Department of Pathology (A.d.R.), Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475 Paris Cedex 10, France; INSERM, UMR 1101 LaTIM, Brest, France (M.M., D.V., M.H.); Department of Nuclear Medicine, CHU Bordeaux, University of Bordeaux, Bordeaux, France (E.H.); and B2T, Doctoral School, IUH, University of Paris VII, Paris, France (D.G., P.M.)
| | - Mathieu Hatt
- From the Department of Nuclear Medicine (D.G., A.M., P.M.), Department of Statistical Sciences (A.S., M.R.R.), Department of Biochemistry (P.d.C.), Breast Diseases Unit and Department of Medical Oncology (S.G., M.E.), and Department of Pathology (A.d.R.), Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475 Paris Cedex 10, France; INSERM, UMR 1101 LaTIM, Brest, France (M.M., D.V., M.H.); Department of Nuclear Medicine, CHU Bordeaux, University of Bordeaux, Bordeaux, France (E.H.); and B2T, Doctoral School, IUH, University of Paris VII, Paris, France (D.G., P.M.)
| | - Marc Espié
- From the Department of Nuclear Medicine (D.G., A.M., P.M.), Department of Statistical Sciences (A.S., M.R.R.), Department of Biochemistry (P.d.C.), Breast Diseases Unit and Department of Medical Oncology (S.G., M.E.), and Department of Pathology (A.d.R.), Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75475 Paris Cedex 10, France; INSERM, UMR 1101 LaTIM, Brest, France (M.M., D.V., M.H.); Department of Nuclear Medicine, CHU Bordeaux, University of Bordeaux, Bordeaux, France (E.H.); and B2T, Doctoral School, IUH, University of Paris VII, Paris, France (D.G., P.M.)
| |
Collapse
|
43
|
Groheux D, Sanna A, Majdoub M, de Cremoux P, Giacchetti S, Teixeira L, Espié M, Merlet P, de Roquancourt A, Visvikis D, Hatt M, Resche-Rigon M, Hindié E. Baseline Tumor 18F-FDG Uptake and Modifications After 2 Cycles of Neoadjuvant Chemotherapy Are Prognostic of Outcome in ER+/HER2− Breast Cancer. J Nucl Med 2015; 56:824-31. [DOI: 10.2967/jnumed.115.154138] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 03/10/2015] [Indexed: 11/16/2022] Open
|
44
|
Humbert O, Cochet A, Coudert B, Berriolo-Riedinger A, Kanoun S, Brunotte F, Fumoleau P. Role of positron emission tomography for the monitoring of response to therapy in breast cancer. Oncologist 2015; 20:94-104. [PMID: 25561512 DOI: 10.1634/theoncologist.2014-0342] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
This review considers the potential utility of positron emission tomography (PET) tracers in the setting of response monitoring in breast cancer, with a special emphasis on glucose metabolic changes assessed with (18)F-fluorodeoxyglucose (FDG). In the neoadjuvant setting of breast cancer, the metabolic response can predict the final complete pathologic response after the first cycles of chemotherapy. Because tumor metabolic behavior highly depends on cancer subtype, studies are ongoing to define the optimal metabolic criteria of tumor response in each subtype. The recent multicentric randomized AVATAXHER trial has suggested, in the human epidermal growth factor 2-positive subtype, a clinical benefit of early tailoring the neoadjuvant treatment in women with poor metabolic response after the first course of treatment. In the bone-dominant metastatic setting, there is increasing clinical evidence that FDG-PET/computed tomography (CT) is the most accurate imaging modality for assessment of the tumor response to treatment when both metabolic information and morphologic information are considered. Nevertheless, there is a need to define standardized metabolic criteria of response, including the heterogeneity of response among metastases, and to evaluate the costs and health outcome of FDG-PET/CT compared with conventional imaging. New non-FDG radiotracers highlighting specific molecular hallmarks of breast cancer cells have recently emerged in preclinical and clinical studies. These biomarkers can take into account the heterogeneity of tumor biology in metastatic lesions. They may provide valuable clinical information for physicians to select and monitor the effectiveness of novel therapeutics targeting the same molecular pathways of breast tumor.
Collapse
Affiliation(s)
- Olivier Humbert
- Departments of Nuclear Medicine and Medical Oncology, Centre G.F. Leclerc, Dijon, France; Imaging Department, Centre Hospitalo-Universitaire Le Bocage, Dijon, France; Université de Bourgogne, UMR CNRS 6306, Dijon, France
| | - Alexandre Cochet
- Departments of Nuclear Medicine and Medical Oncology, Centre G.F. Leclerc, Dijon, France; Imaging Department, Centre Hospitalo-Universitaire Le Bocage, Dijon, France; Université de Bourgogne, UMR CNRS 6306, Dijon, France
| | - Bruno Coudert
- Departments of Nuclear Medicine and Medical Oncology, Centre G.F. Leclerc, Dijon, France; Imaging Department, Centre Hospitalo-Universitaire Le Bocage, Dijon, France; Université de Bourgogne, UMR CNRS 6306, Dijon, France
| | - Alina Berriolo-Riedinger
- Departments of Nuclear Medicine and Medical Oncology, Centre G.F. Leclerc, Dijon, France; Imaging Department, Centre Hospitalo-Universitaire Le Bocage, Dijon, France; Université de Bourgogne, UMR CNRS 6306, Dijon, France
| | - Salim Kanoun
- Departments of Nuclear Medicine and Medical Oncology, Centre G.F. Leclerc, Dijon, France; Imaging Department, Centre Hospitalo-Universitaire Le Bocage, Dijon, France; Université de Bourgogne, UMR CNRS 6306, Dijon, France
| | - François Brunotte
- Departments of Nuclear Medicine and Medical Oncology, Centre G.F. Leclerc, Dijon, France; Imaging Department, Centre Hospitalo-Universitaire Le Bocage, Dijon, France; Université de Bourgogne, UMR CNRS 6306, Dijon, France
| | - Pierre Fumoleau
- Departments of Nuclear Medicine and Medical Oncology, Centre G.F. Leclerc, Dijon, France; Imaging Department, Centre Hospitalo-Universitaire Le Bocage, Dijon, France; Université de Bourgogne, UMR CNRS 6306, Dijon, France
| |
Collapse
|
45
|
Martens MH, Lambregts DMJ, Kluza E, Beets-Tan RGH. Tumor Response to Treatment: Prediction and Assessment. CURRENT RADIOLOGY REPORTS 2014. [DOI: 10.1007/s40134-014-0062-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|