1
|
Suzuki E, Sasada S, Sueoka S, Masumoto N, Goda N, Kajitani K, Emi A, Haruta R, Kadoya T, Kataoka T, Okada M. Abstract P6-02-09: Diagnostic performance of dedicated breast PET for the prediction of pathological response after neoadjuvant chemotherapy. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-02-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Neoadjuvant chemotherapy (NAC) is a standard treatment for operable breast cancer. However, imaging methods for evaluating treatment response have not been established. Previous studies reported that ring-type dedicated breast positron emission tomography (DbPET) detected residual tumors following NAC more accurately than whole-body PET/CT. This study assessed DbPET parameters for predicting pathological complete response (pCR) in patients with breast cancer.
Patients and Methods: Among patients with breast cancer who underwent surgery after NAC, 61 were examined using ring-type DbPET before and after NAC. The maximum standardized uptake values (SUVmax) and tumor-to-normal-tissue ratio (TNR) were calculated before and after NAC (pre-SUVmax, pre-TNR, post-SUVmax and post-TNR, respectively). Moreover, the reduction rates (ΔSUVmax and ΔTNR) were determined. pCR was defined as complete remission of breast cancer.
Results: The median patient age was 52 years. Forty patients (65.6%) were estrogen receptor (ER)-positive, whereas 25 patients (41.0%) were HER2-positive. Fifteen patients (24.6%) achieved pCR after NAC. The calculated values for the parameters of DbPET are summarized in Table 1. The most promising parameters for predicting pCR were ΔSUVmax (area under the curve [AUC]: 0.506) and post-TNR (AUC: 0.640). Although neither of these two parameters reflected the pathological response to NAC in patients with ER-positive disease, post-TNR showed the highest AUC (i.e., AUC: 0.750) for pCR in patients with ER-negative disease. The sensitivity and specificity of post-TNR in the ER-positive group were 85.7% and 39.4%, respectively. In the ER-negative group, these values were 100% and 58.3%, respectively [Table 2]
Table 1.Diagnostic performance of dedicated breast positron-emission tomography for the prediction of pathological complete response after neoadjuvant chemotherapyParameterspCR Median (IQR)Non-pCR Median (IQR)PAUC (95% CI)Pre-SUVmax14.8 (9.2–17.7)14.4 (10.7–19.8)0.6040.454 (0.285–0.624)Post-SUVmax1.8(1.5–2.1)2.0 (1.6–3.4)0.2370.603 (0.460–0.746)ΔSUVmax (%)87.32 (81.5–91.8)88.6(82.8–91.8)0.9540.506 (0.329–0.682)Pre-TNR8.0 (5.3–9.2)7.3(5.9–10.2)0.7570.472 (0.297–0.647)Post-TNR1.7(1.0–1.1)1.2 (1.0–2.4)0.0980.640 (0.506–0.774)ΔTNR (%)87.3 (78.3–89.1)79.8 (62.7–86.7)0.1130.638 (0.472–0.803)pCR, pathological complete response; IQR, interquartile range; AUC, area under the curve; CI, confidence interval, SUV, standardized uptake value; TNR, tumor-to-normal-tissue ratio.Table 2.Diagnostic accuracy of post-TNR according to estrogen receptor status Sensitivity (%)Specificity (%)Accuracy (%)PPV (%)NPV (%)ER-positive85.739.447.523.192.9ER-negative10058.375.061.5100TNR, tumor-to-normal-tissue ratio; ER, estrogen receptor; PPV, positive predictive value; NPV, negative predictive value
Conclusion: In DbPET, ΔSUVmax and post-TNR were shown to be promising parameters for predicting pathological response to NAC. Post-TNR provided the highest sensitivity for predicting pCR in patients with ER-negative breast cancer.
Citation Format: Suzuki E, Sasada S, Sueoka S, Masumoto N, Goda N, Kajitani K, Emi A, Haruta R, Kadoya T, Kataoka T, Okada M. Diagnostic performance of dedicated breast PET for the prediction of pathological response after neoadjuvant chemotherapy [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-02-09.
Collapse
Affiliation(s)
- E Suzuki
- Hiroshima University, Hiroshima City, Japan
| | - S Sasada
- Hiroshima University, Hiroshima City, Japan
| | - S Sueoka
- Hiroshima University, Hiroshima City, Japan
| | - N Masumoto
- Hiroshima University, Hiroshima City, Japan
| | - N Goda
- Hiroshima University, Hiroshima City, Japan
| | - K Kajitani
- Hiroshima University, Hiroshima City, Japan
| | - A Emi
- Hiroshima University, Hiroshima City, Japan
| | - R Haruta
- Hiroshima University, Hiroshima City, Japan
| | - T Kadoya
- Hiroshima University, Hiroshima City, Japan
| | - T Kataoka
- Hiroshima University, Hiroshima City, Japan
| | - M Okada
- Hiroshima University, Hiroshima City, Japan
| |
Collapse
|
2
|
Masumoto N, Kadoya T, Suzuki E, Sueoka S, Goda N, Sasada S, Emi A, Haruta R, Kataoka T, Okada M. Intratumoral heterogeneity on dedicated breast positron emission tomography before chemotherapy predicts the outcome of neoadjuvant chemotherapy in breast cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy271.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
3
|
Sueoka S, Sasada S, Suzuki E, Goda N, Kajitani K, Emi A, Masumoto N, Kadoya T, Haruta R, Kataoka T, Okada M. Molecular subtyping of breast cancer by dedicated breast PET. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy270.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
4
|
Kimura Y, Sasada S, Goda N, Kajitani K, Emi A, Masumoto N, Kadoya T, Haruta R, Kataoka T, Okada M. Histology and detectability on ring-type dedicated breast PET in breast cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy294.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
5
|
Sasada S, Shiroma N, Suzuki E, Sueoka S, Goda N, Kajitani K, Emi A, Masumoto N, Kadoya T, Haruta R, Kataoka T, Arihiro K, Okada M. Relationship between ring-type dedicated breast PET and tumor-infiltrating lymphocytes in early breast cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy269.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
6
|
Masumoto N, Kadoya T, Nishina M, Kimura Y, Suzuki E, Sueoka S, Goda N, Sasada S, Kajitani K, Emi A, Haruta R, Kataoka T, Okada M. Abstract P5-02-03: Evaluation of pathological malignancy grade and neoplastic progress of breast cancer using dedicated breast positron emission tomography. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-02-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Dedicated breast positron emission tomography (DbPET)provides detailed high resolution images of the breast and enables quantitative assessment using standard uptake values (SUVs). We aimed to determine whether DbPET can predict the pathological malignancy grade and neoplastic progress of breast cancer compared with whole body (WB) PET.
Methods: We investigated 196 consecutive patients with invasive breast cancerwho underwent concurrent Db- and WB-PET from January 2016 to March 2017. All Db- and WB-PET were quantified based on SUVs. We also investigated pathological features of breast cancer who had a ring-like uptake (RU) without central FDG accumulation on DbPET.
Results:
The associations between the SUVs for DB- and WB-PET and the pathological factors in breast cancerCharacteristicSUV WBPETDbPET Mean ± SDpMean ± SDpall3.6 ± 3.4 9.4±7.9 Tumor size ≤2.0 cm2.2±1.6<0.0016.5±5.2<0.001>2.0 cm5.5±4.1 13.3±9.2 LN Negative3.1±3.3<0.0018.4±7.8<0.001Positive4.9±3.2 11.8±7.7 NG 1 or 22.4±2.1<0.0016.6±5.9<0.00135.1±4.0 12.7±8.7 Ki67 < 201.8±1.1<0.0015.2±3.3<0.001≥ 204.4±3.7 11.4±8.6 ER positive3.4±3.30.028.8±7.60.006negative5.2±3.6 13.5±8.6 HER-2 positive4.6±3.10.0911.8±7.60.04negative3.4±3.4 9.0±7.9 Sub type vs Lumnal A vs Lumnal ALuminal A1.8±1.1 5.2±3.3 Luminal B4.0±3.8<0.00110.1±8.5<0.001HER24.6±3.1<0.00111.8±7.6<0.001Triple negative5.3±3.8<0.00113.8±9.2<0.001
summarizes the association between SUVs for Db- and WB-PET and pathological factors inbreast cancer.SUVs on PET were significantly higher for the tumor size of >2.0 cm than for tumor size ≤2.0 cm (p<0.001), for LN-positive than for LN-negative (p<0.001), for NG3 than for NG1-NG2 (p<0.001), for higher Ki67 expression than for lower Ki67 expression (p<0.001), and for ER-negative than for ER-positive (WBPET, p=0.02; DbPET, p=0.006). SUVs were significantly lower for Luminal A than for Luminal B, HER2, and triple-negative cancer (p<0.001 for all three).SUVs for DbPET was significantly higher for HER2-positive than for HER2-negative (p=0.02).
The association between SUVs for breast cancer with and without RU on DbPETCharacteristicRU(-), nRU(+), npall17323 Tumor size ≤2.0 cm1095<0.001>2.0 cm6418 LN Negative1299<0.001Positive4414 NG 1 or 210070.0237316 Ki67 < 206130.03≥ 2011220 ER positive152190.49negative214 HER-2 positive2620.38negative14721 Sub type vs Lumnal ALuminal A493 Luminal B84150.02HER22620.81Triple negative1430.04
summarizes the association between SUVs for breast cancer with and without RU on DbPET. SUVs for breast cancer with RU on DbPET were significantly higher for the tumor size of >2.0 cm than for tumor size ≤2.0 cm, for LN -positive than for LN-negative (p<0.001), for NG3 than for NG1-2 (p=0.02), and for higher Ki67 expression than for lowerKi67 expression (p=0.03). SUVs were significantly lower for Luminal A than for Luminal B (p=0.02) and triple-negative cancer (p=0.04).
Conclusions: SUVs for DbPET were equal or superiorto WBPET in predicting the pathological malignancy grade and neoplastic progress in tumors. Furthermore, the presence of RU on DbPET can provide excellent predictive value for high-grade malignancy and might help to determine appropriate therapeutic strategies.
Citation Format: Masumoto N, Kadoya T, Nishina M, Kimura Y, Suzuki E, Sueoka S, Goda N, Sasada S, Kajitani K, Emi A, Haruta R, Kataoka T, Okada M. Evaluation of pathological malignancy grade and neoplastic progress of breast cancer using dedicated breast positron emission tomography [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-02-03.
Collapse
Affiliation(s)
- N Masumoto
- Hiroshima University, Hiroshima; Hiroshima University Hospital, Hiroshima
| | - T Kadoya
- Hiroshima University, Hiroshima; Hiroshima University Hospital, Hiroshima
| | - M Nishina
- Hiroshima University, Hiroshima; Hiroshima University Hospital, Hiroshima
| | - Y Kimura
- Hiroshima University, Hiroshima; Hiroshima University Hospital, Hiroshima
| | - E Suzuki
- Hiroshima University, Hiroshima; Hiroshima University Hospital, Hiroshima
| | - S Sueoka
- Hiroshima University, Hiroshima; Hiroshima University Hospital, Hiroshima
| | - N Goda
- Hiroshima University, Hiroshima; Hiroshima University Hospital, Hiroshima
| | - S Sasada
- Hiroshima University, Hiroshima; Hiroshima University Hospital, Hiroshima
| | - K Kajitani
- Hiroshima University, Hiroshima; Hiroshima University Hospital, Hiroshima
| | - A Emi
- Hiroshima University, Hiroshima; Hiroshima University Hospital, Hiroshima
| | - R Haruta
- Hiroshima University, Hiroshima; Hiroshima University Hospital, Hiroshima
| | - T Kataoka
- Hiroshima University, Hiroshima; Hiroshima University Hospital, Hiroshima
| | - M Okada
- Hiroshima University, Hiroshima; Hiroshima University Hospital, Hiroshima
| |
Collapse
|
7
|
Sueoka S, Masumoto N, Nishina M, Kimura Y, Suzuki E, Goda N, Sasada S, Kajitani K, Emi A, Haruta R, Kadoya T, Kataoka T, Okada M. Abstract P6-03-08: Detection ability of dedicated breast positron emission tomography for small-sized breast cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-03-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Whole body (WB) 18F-fluorodeoxyglucose positron emission tomography (PET) has a relatively poor spatial resolution (>1 cm), which limits the capability to detect small lesions. Therefore, small-sized breast cancers (≤1 cm) may not be visible on WBPET. To overcome these limitations, dedicated breast PET (DbPET) has been developed to improve spatial resolution. DbPET enables detailed high-resolution images within the breast. We aimed to determine whether DbPET can detect small-sized breast cancer compared to WBPET.
Methods: We investigated 203 consecutive patients (217 tumors) (T1–3, N0–3a, M0) with breast cancer who underwent concurrent DbPET and WBPET between January 2016 and March 2017. All DbPET and WBPET images were semi-quantified based on standard uptake values. The diagnostic performance of each scanner was assessed in DbPET and WBPET. Tumors were classified based on pathological classification as follows: Tis, ductal carcinoma in situ (DCIS); T1a, ≤0.5 cm; T1b, 0.5–1 cm; and T1c, 1–2 cm; T2, 2–5 cm; T3, >5 cm. The sensitivities of DbPET and WBPET were compared in each size group.
Results: Table 1 shows the detection rate of breast cancer in WBPET and DbPET
The detection rate of breast cancer in WB- and Db-PET DbPETWBPETpTumor sizeDetection (-) n(%)Detection (+) n(%)Detection (-) n(%)Detection (+) n(%) Tis6(14.6)35(85.4)18(43.9)23(56.1)0.0030T1a2(8)23(92)7(28)18(72)0.0594T1b2(6.5)29(93.5)10(32.3)21(67.7)0.0077T1c5(8.2)56(91.8)11(18)50(82)0.1038T20(0)57(100)1(1.8)56(98.2)0.2375T30(0)2(100)0(0)2(100)-total15(6.9)202(93.1)47(21.7)170(78.3)<0.0001
. The overall detection rate in DBPET [93.1% (202/217)] was significantly higher than that of WBPET [78.3% (170/217)] (P < 0.001). For smaller tumors, DbPET was more sensitive than WBPET: Tis (85.4% vs. 56.1%), T1a (92% vs. 72%), T1b (93.5% vs. 67.7%), T1c (91.8% vs. 82%), T2 (100% vs. 98.2%), and T3 (100% vs. 100%). The sensitivity of DbPET was significantly higher than that of WBPET in Tis (P = 0.003) and T1b (P = 0.008) and tended to be higher than that of WBPET in T1a (P = 0.059). Conversely, no significant differences were observed in T1c (P = 0.103) and T2 (P = 0.238).
Conclusion: The imaging sensitivity of DbPET was higher than that of WBPET. DbPET showed significant sensitivity in DCIS and tumors ≤1 cm, which is a weak point for WBPET. DbPET may serve as a new diagnostic modality to detect small-sized breast cancer.
Citation Format: Sueoka S, Masumoto N, Nishina M, Kimura Y, Suzuki E, Goda N, Sasada S, Kajitani K, Emi A, Haruta R, Kadoya T, Kataoka T, Okada M. Detection ability of dedicated breast positron emission tomography for small-sized breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-03-08.
Collapse
Affiliation(s)
- S Sueoka
- Hiroshima University Hospital, Hiroshima, Japan
| | - N Masumoto
- Hiroshima University Hospital, Hiroshima, Japan
| | - M Nishina
- Hiroshima University Hospital, Hiroshima, Japan
| | - Y Kimura
- Hiroshima University Hospital, Hiroshima, Japan
| | - E Suzuki
- Hiroshima University Hospital, Hiroshima, Japan
| | - N Goda
- Hiroshima University Hospital, Hiroshima, Japan
| | - S Sasada
- Hiroshima University Hospital, Hiroshima, Japan
| | - K Kajitani
- Hiroshima University Hospital, Hiroshima, Japan
| | - A Emi
- Hiroshima University Hospital, Hiroshima, Japan
| | - R Haruta
- Hiroshima University Hospital, Hiroshima, Japan
| | - T Kadoya
- Hiroshima University Hospital, Hiroshima, Japan
| | - T Kataoka
- Hiroshima University Hospital, Hiroshima, Japan
| | - M Okada
- Hiroshima University Hospital, Hiroshima, Japan
| |
Collapse
|
8
|
Sasada S, Masumoto N, Goda N, Kajitani K, Emi A, Haruta R, Kadoya T, Kataoka T, Okada M. Stealth breast cancer on ring-type dedicated breast PET. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx672.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
9
|
Sasada S, Kadoya T, Goga N, Emi A, Kajitani K, Masumoto N, Haruta R, Kataoka T, Okada M. Dedicated breast PET for predicting residual disease after breast cancer neoadjuvant chemotherapy. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx362.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
10
|
Masumoto N, Kadoya T, Murakami C, Gouda N, Sasada S, Emi A, Haruta R, Kataoka T, Okada M. Abstract P4-02-06: Evaluation of contrast-enhanced ultrasonography for early prediction of response to neoadjuvant chemotherapy in triple negative breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-02-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Objectives
We aimed to determine whether contrast-enhanced ultrasonography (CEUS) can predict the early effects of neoadjuvant chemotherapy on triple negative breast cancer.
Methods
The clinical responses of 20 consecutive patients with breast cancer (T1–2, N0–1, M0) to neoadjuvant chemotherapy between October 2012 and Feb 2016 were assessed using ultrasonography and contrast-enhanced ultrasonography before starting the therapy and after the treatment of 2 courses. Ascending slope (AS) of perfusion parameters for contrast-enhanced ultrasonography were created from time–intensity curves based on enhancement intensity and temporal changes to objectively evaluate contrast-enhanced ultrasonography findings.We investigated whether rate of change of ascending slope (ΔAS) and tumor size (Δ US) could predict pCR.
Results
Eight (40.0%) of the 20 patients achieved pathological complete response. ΔAS were significantly higher (-25.5 ± 35.5 vs. 14.7 ± 33.2; P < 0.02) in patients who achieved pCR than in those who did not. On the other hand, ΔUS of pCR and non-pCR did not significantly differ among tumors (-40.8 ± 22.4 vs. -21.4 ± 20.6; P = 0.06). The AUC values for ΔAS and ΔUS were 0.792 (95% CI, 0.579 -1.000, P = 0.03) and 0.729 (95% CI, 0.501 - 0.957;p = 0.09), respectively. We set ΔAS and Δ US cut-offs for predicting pCR at-20.08 and - 33.75 based on the ROC curves. Clinical and pathological characteristics of the 20 patients are summarized in Univariate (odds ratio, 2.71; p= 0.02) and multivariate (odds ratio, 2.88; p= 0.03) analysis showed that ΔAS was the sole independent predictor of pCR.
Clinical and pathological characteristics of patients with breast cancer.CharacteristicpCR (n)Non pCR (n)pClinical T status T1110.71T2711 Clinical N status Negative570.85Positive35 Nuclear Grade 1 or 2340.85358 ΔUS (%) < -33.75390.09≥ -33.7553 ΔAS (%) < -20.082100.009≥ -20.0862
Univariate and multivariate logistic analysis of significant predictive factors for pCR in triple negative subtype Univariate analysisMultivariate analysis OR, 95% CI, pOR, 95% CI, pΔUS > -33.751.61, 0.72-34.7, 0.101.85, 0.51-79.1, 0.15≤-33.75 ΔAS > -20.082.71, 1.65-136.1, 0.022.88, 1.44-218.7, 0.03≤ -20.08
Conclusion
ΔAS assessed with CEUS can help the physician to early predict the probability of achieving pCR or not.
Citation Format: Masumoto N, Kadoya T, Murakami C, Gouda N, Sasada S, Emi A, Haruta R, Kataoka T, Okada M. Evaluation of contrast-enhanced ultrasonography for early prediction of response to neoadjuvant chemotherapy in triple negative breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-02-06.
Collapse
Affiliation(s)
- N Masumoto
- Hiroshima University; Hiroshima University Hospital
| | - T Kadoya
- Hiroshima University; Hiroshima University Hospital
| | - C Murakami
- Hiroshima University; Hiroshima University Hospital
| | - N Gouda
- Hiroshima University; Hiroshima University Hospital
| | - S Sasada
- Hiroshima University; Hiroshima University Hospital
| | - A Emi
- Hiroshima University; Hiroshima University Hospital
| | - R Haruta
- Hiroshima University; Hiroshima University Hospital
| | - T Kataoka
- Hiroshima University; Hiroshima University Hospital
| | - M Okada
- Hiroshima University; Hiroshima University Hospital
| |
Collapse
|
11
|
Amioka A, Masumoto N, Kajitani K, Emi A, Shigematsu H, Kadoya T, Haruta R, Kataoka T, Arihiro K, Okada M. Abstract P2-03-07: Prediction of the pathological response to neoadjuvant chemotherapy in patients with breast cancer using sonazoid-enhanced ultrasonography. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p2-03-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
Altered blood flow in malignant tumors is evidenced by contrast-enhanced ultrasonography (CEUS) because of its image perfusion capabilities.
This study aimed to investigate the value of CEUS in the evaluation of the response of breast cancer lesions to neoadjuvant chemotherapy (NAC). We evaluated whether the prediction of a pathological complete response (pCR) using CEUS was more precise than that using other standard evaluation methods such as magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT).
Methods:
Ten patients (mean age, 50.2 years) who underwent NAC for invasive breast cancer between September 2012 and April 2013 were eligible for this cohort study. Clinical tumor response was evaluated using contrast-enhanced MRI, PET/CT, and CEUS following NAC. A pCR was defined as the absence of invasive cancer in the breast and lymph nodes according to the Japanese Breast Cancer Society criteria.
A clinically complete response (cCR) was defined as the absence of residual disease on MRI and PET/CT. The HI VISION ASCENDUS (Hitachi Aloka Medical Corp.) was used for ultrasonography. Tumors were observed 50 s after Sonazoid injection at a dose of 0.01 ml/kg. A time-intensity curve of tumor signal intensity was drawn. The brightness of the tumor was digitized and the curve was created on the basis of brightness changes over time. The intensity of brightness of the breast cancer lesions was calculated as the increased rate of brightness (IRB) using the following formula: maximal intensity/intensity before contrast.
Results:
Four (40%) of the 10 patients were diagnosed with pCR by NAC. Among 4 (40%) patients diagnosed with cCR by MRI, 1 (25%) achieved pCR. All patients were diagnosed with pCR by PET/CT. The IRB values of the 10 patients who received CEUS before surgery were 1.0, 1.1, 1.2, 1.2, 1.3, 1.6, 1.8, 1.9, 2.5, and 4.2. The IRB values of the 4 patients diagnosed with pCR were 1.0, 1.1, 1.2, and 1.2. IRB values were significantly lower in patients who achieved pCR than in those who did not (pCR vs. no pCR, 1.1 ± 0.9 vs. 2.2 ± 1.0, P < 0.05). Furthermore, among the patients who achieved pCR, the IRB values of 2 patients with no residual ductal carcinoma in situ (DCIS) were 1.0 and 1.1, whereas those of 2 patients with residual DCIS were both 1.2.
In the 4 patients who achieved cCR as diagnosed by MRI and PET/CT, 3 with pathological residual disease had detectable IRB by CEUS.
table 1caseageStageSub typeMRIPET-CTpathological responseIncrease rate of brightness (IRB)167T2N1 IIBLuminal HER2PRCRCR1237T2N0 IIAHER2 positivePRCRCR1.1346T3N1 IIIAHER2 positiveCRCRCR1.2446T2N3c IIICLuminal HER2PRCRCR1.2564T2N0 IIAHER-2 positiveCRCRPR1.3658T2N1 IIBLuminal BCRCRPR1.6738T2N0 IIALuminal BPRCRPR1.8857T1cN0 ILuminal HER-2PRCRPR1.9939T2N1 IIBLuminalBSDCRSD2.51050T2N1 IIBTriple negativePRCRSD4.2
Conclusions:
The prediction of pCR after NAC in patients with breast cancer is more precise with Sonazoid-enhanced ultrasonography than with standard methods such as MRI and PET/CT. Furthermore, CEUS may be useful for predicting residual DCIS on the basis of brightness intensity.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-03-07.
Collapse
Affiliation(s)
- A Amioka
- Department of Surgical Oncology, Hiroshima-shi, Hiroshima-ken, Japan; Department of Breast Surgery, Hiroshima-shi, Hiroshima-ken, Japan; Department of Anatomical Pathology, Hiroshima-shi, Hiroshima-ken, Japan
| | - N Masumoto
- Department of Surgical Oncology, Hiroshima-shi, Hiroshima-ken, Japan; Department of Breast Surgery, Hiroshima-shi, Hiroshima-ken, Japan; Department of Anatomical Pathology, Hiroshima-shi, Hiroshima-ken, Japan
| | - K Kajitani
- Department of Surgical Oncology, Hiroshima-shi, Hiroshima-ken, Japan; Department of Breast Surgery, Hiroshima-shi, Hiroshima-ken, Japan; Department of Anatomical Pathology, Hiroshima-shi, Hiroshima-ken, Japan
| | - A Emi
- Department of Surgical Oncology, Hiroshima-shi, Hiroshima-ken, Japan; Department of Breast Surgery, Hiroshima-shi, Hiroshima-ken, Japan; Department of Anatomical Pathology, Hiroshima-shi, Hiroshima-ken, Japan
| | - H Shigematsu
- Department of Surgical Oncology, Hiroshima-shi, Hiroshima-ken, Japan; Department of Breast Surgery, Hiroshima-shi, Hiroshima-ken, Japan; Department of Anatomical Pathology, Hiroshima-shi, Hiroshima-ken, Japan
| | - T Kadoya
- Department of Surgical Oncology, Hiroshima-shi, Hiroshima-ken, Japan; Department of Breast Surgery, Hiroshima-shi, Hiroshima-ken, Japan; Department of Anatomical Pathology, Hiroshima-shi, Hiroshima-ken, Japan
| | - R Haruta
- Department of Surgical Oncology, Hiroshima-shi, Hiroshima-ken, Japan; Department of Breast Surgery, Hiroshima-shi, Hiroshima-ken, Japan; Department of Anatomical Pathology, Hiroshima-shi, Hiroshima-ken, Japan
| | - T Kataoka
- Department of Surgical Oncology, Hiroshima-shi, Hiroshima-ken, Japan; Department of Breast Surgery, Hiroshima-shi, Hiroshima-ken, Japan; Department of Anatomical Pathology, Hiroshima-shi, Hiroshima-ken, Japan
| | - K Arihiro
- Department of Surgical Oncology, Hiroshima-shi, Hiroshima-ken, Japan; Department of Breast Surgery, Hiroshima-shi, Hiroshima-ken, Japan; Department of Anatomical Pathology, Hiroshima-shi, Hiroshima-ken, Japan
| | - M Okada
- Department of Surgical Oncology, Hiroshima-shi, Hiroshima-ken, Japan; Department of Breast Surgery, Hiroshima-shi, Hiroshima-ken, Japan; Department of Anatomical Pathology, Hiroshima-shi, Hiroshima-ken, Japan
| |
Collapse
|
12
|
Ban N, Nakaoka H, Haruta R, Murakami Y, Kubo T, Maeda T, Kusama T. Development of a real-time hand dose monitor for personnel in interventional radiology. Radiat Prot Dosimetry 2001; 93:325-329. [PMID: 11548359 DOI: 10.1093/oxfordjournals.rpd.a006444] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Medical procedures denoted as interventional radiology require operation near an X ray beam, which brings high dose exposures to the operators' hands. For the effectual control of their extremity doses, a prototype of a real-time wrist dosemeter has been developed, hand dose monitor (HDM), based on a single silicon detector. Experiments were performed to test its response to diagnostic X rays. The HDM was highly sensitive and showed a linear response down to doses of a few tens of microsieverts. Though dose rate, energy and angular dependence of the response were observed in some extreme conditions, the HDM was proved to be of practical use if it was appropriately calibrated. Since an HDM enables personnel to check their hand doses on a real-time basis, it would enable medical staff to control the exposure themselves.
Collapse
Affiliation(s)
- N Ban
- Oita University of Nursing and Health Sciences, 2944-9 Megusuno, Notsuharu, Oita 870-1201, Japan.
| | | | | | | | | | | | | |
Collapse
|
13
|
Kohashi T, Kataoka T, Haruta R, Sugino K, Marubayashi S, Yahata H, Asahara T, Fujii S, Arihiro K, Dohi K. Granular cell tumor of the breast: report of a case. Hiroshima J Med Sci 1999; 48:31-3. [PMID: 10213961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
A case of granular cell tumor of the breast in a 43-year-old woman is described. The patient presented with a painless mass in the upper-outer quadrant of her right breast. Mammography showed a spiculated tumor and ultrasonography demonstrated a hypoechoic mass with an irregular border. Magnetic resonance (MR) mammography revealed a homogeneous enhanced mass in T1-weighted images using Gd-DTPA and a ringed high-intensity area around the mass in T2-weighted images. Fine-needle aspiration cytology failed to show any malignant cells. A partial resection of the breast was performed and histological examination revealed a granular cell tumor. Granular cell tumors are generally always benign, but they may be misdiagnosed as malignant tumors because of their mammographic and ultrasonographic findings. MR mammography did not reveal a typical breast cancer in either T1- or T2-weighted images in the present case. This case illustrates the need for care in preoperative examinations in order to avoid overdiagnosis of breast cancer.
Collapse
Affiliation(s)
- T Kohashi
- Second Department of Surgery, Hiroshima University School of Medicine, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Kataoka T, Kadoya T, Sugi K, Takahashi M, Gotoh T, Haruta R, Asahara T, Dohi K, Nishiki M, Arihiro K. Early Breast Cancer Following Treatment of Myelodysplastic Syndrome: Report of a Case. Breast Cancer 1998; 5:183-186. [PMID: 11091646 DOI: 10.1007/bf02966693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 45-year-old woman was admitted to our hospital complaining of a mass in herleft breast. She had previously been diagnosed with myelodysplastic syndrome(MDS), a type of refractory anemia, based on bone marrow findings and chromosome analysis. She received a preoperative transfusion of fresh packed platelets and a recombinant human granulocyte colony-stimulating factor(rhG-CSF)injection. Left partial mastectomy and axillary lymph nodes dissection were performed to treat early breast cancer. Postoperatively, prophylactic radiotherapy of the residual breast and administration of medroxyprogesterone acetate(MPA)were performed because the tumor tissue was positive for progesterone receptors. She has remained clinically stable, with no evidence of recurrence, for more than three years to date. We report a rare case of breast cancer with MDS, treated with breast-conserving therapy. The strategy of pre- or postoperative platelet transfusion, rhG-CSFinjections, and hormonal therapy (MPA) appears to be suitable treatment for progesterone receptor(PgR)-positive breast cancer patients with MDS.
Collapse
Affiliation(s)
- T Kataoka
- Second Department of Surgery, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Kataoka T, Haruta R, Goto T, Sugino K, Asahara T, Dohi K, Kaneco M, Arihiro K, Nomura S. Malignant phyllodes tumor of the breast with hypoglycemia: report of a case. Jpn J Clin Oncol 1998; 28:276-80. [PMID: 9657015 DOI: 10.1093/jjco/28.4.276] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A surgically resected case of giant malignant phyllodes tumor of the breast associated with a hypoglycemic attack is reported. A 54-year-old woman was referred to our hospital with loss of consciousness and a huge chest wall tumor. She was diagnosed as having a malignant phyllodes tumor by core needle biopsy and underwent palliative simple mastectomy because lung metastasis was detected on computed tomography and by other imaging modalities on admission. The preoperative laboratory data revealed a very low fasting blood sugar level of 37 mg/dl. After removal of the tumor, the blood sugar level gradually normalized (90-100 mg/dl) and the plasma insulin-like growth factor-II (IGF-II) level promptly decreased. The IGF-II level of tumor extracts was high (2500 ng/g wet weight) and the majority of atypical cells stained positively for IGF-II immunohistochemically. These findings suggested that the patient's hypoglycemia was associated with IGF-II produced by a giant malignant phyllodes tumor that consumed glucose.
Collapse
Affiliation(s)
- T Kataoka
- Second Department of Surgery, Hiroshima University School of Medicine, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Kataoka T, Goto T, Haruta R, Dohi K. [Neoadjuvant therapy followed by administration of UFT for breast cancer patients]. Gan To Kagaku Ryoho 1996; 23:369-72. [PMID: 8712833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- T Kataoka
- Second Department of Surgery, Hiroshima University School of Medicine, Japan
| | | | | | | |
Collapse
|
17
|
Abstract
The relationship between the histological grade of dedifferentiation of thyroid cancer and estrogen receptors (ER) was examined immunohistochemically. Thyroid cancers were from postmenopausal females of almost the same mean age (69-73 years old) and within the same period of time (1974-1983). ER immunoreactivity located in the nucleus of the epithelium was found in all 6 well differentiated papillary cancers, and 5 of them (83.3%) showed ER-immunoreactive (ER-IR) cells amounting to 20 or more per visual field (x 100) under a light microscope. Of the 6 cases of poorly differentiated papillary cancer, 5 (83.3%) had 1-19 ER-IR cells per visual field. ER-IR cells were negative in 5 out of 6 cases (83.3%) of anaplastic cancers. Thus, the number of ER-IR cells tended to decrease with the degree of atypism of thyroid cancer (P less than 0.001).
Collapse
Affiliation(s)
- N Takeichi
- Department of Surgery, Hiroshima University School of Medicine
| | | | | | | | | | | |
Collapse
|
18
|
Sakatani K, Manno S, Yamada K, Ogawa R, Ohta T, Haruta R, Mimura O, Shimo-oku M, Kani K. [A new numerical representation of visual field in patients with chiasmal tumor]. Neurol Med Chir (Tokyo) 1988; 28:1046-51. [PMID: 2466206 DOI: 10.2176/nmc.28.1046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
|
19
|
Yokozaki H, Takekura N, Takanashi A, Tabuchi J, Haruta R, Tahara E. Estrogen receptors in gastric adenocarcinoma: a retrospective immunohistochemical analysis. Virchows Arch A Pathol Anat Histopathol 1988; 413:297-302. [PMID: 2845639 DOI: 10.1007/bf00783021] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Estrogen receptors (ER) in human gastric carcinomas were examined immunohistochemically using a specific monoclonal antibody to human ER. ER-immunoreactivity (ER-IR) was positive in 30 (27.8%) of the 108 gastric carcinomas examined. ER-IR was located in the nucleus of cancer cells. The incidence of ER-IR positive gastric carcinoma was not significantly different between male and female cases. However, the positive tumour cells were observed in 28 (39.4%) out of the 71 poorly differentiated adenocarcinoma, the incidence being significantly higher than that in well differentiated adenocarcinoma (p less than 0.01). There was no significant difference in the incidence of ER-IR between scirrhous carcinoma and non-scirrhous poorly differentiated adenocarcinoma. Synchronous expression of ER and epidermal growth factor receptor was found in 8 of the 26 scirrhous carcinomas (30.8%). Patients with ER-IR positive scirrhous gastric carcinomas showed a much worse prognosis than those with ER-IR negative scirrhous carcinomas.
Collapse
Affiliation(s)
- H Yokozaki
- Department of Pathology, Hiroshima University School of Medicine, Japan
| | | | | | | | | | | |
Collapse
|
20
|
Matsuyama T, Takeichi N, Okamoto H, Mori M, Haruta R, Dohi K. Differential diagnosis of nodular goiter by means of aspiration biopsy cytology--results in recent five years. Hiroshima J Med Sci 1987; 36:271-6. [PMID: 3692891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|