Feasibility of FDG PET-CT to monitor the response of axillary lymph node metastases to neoadjuvant chemotherapy in breast cancer patientsReportar como inadecuado

Feasibility of FDG PET-CT to monitor the response of axillary lymph node metastases to neoadjuvant chemotherapy in breast cancer patients - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

European Journal of Nuclear Medicine and Molecular Imaging

, Volume 37, Issue 6, pp 1069–1076

First Online: 04 February 2010Received: 01 October 2009Accepted: 17 November 2009


PurposeThe aim of this study was to assess the accuracy of F-fluorodeoxyglucose FDG positron emission tomography PET-CT to visualize lymph node metastases before the start of neoadjuvant chemotherapy and to determine how often the visualization is sufficiently prominent to allow monitoring of the axillary response.

MethodsThirty-eight patients with invasive breast cancer of >3 cm and-or lymph node metastasis underwent FDG PET-CT before neoadjuvant chemotherapy. The results of the FDG PET-CT were compared with those from ultrasonography with fine-needle aspiration FNA cytology or sentinel node biopsy. Patients suitable for response monitoring of the axilla were defined as having either a maximum standardized uptake value SUVmax ≥ 2.5 or a tumour to background ratio ≥5 in the most intense lymph node.

ResultsThe sensitivity and specificity of FDG PET-CT in detecting axillary involvement were 97 and 100%, respectively. No difference existed between the SUVmax of the primary tumour and that from the related most intense lymph node metastasis. Moreover, the mean tumour to background ratio was 90% higher in the lymph nodes compared to the primary tumour p = 0.006. Ninety-three per cent of the patients had sufficient uptake in the lymph nodes to qualify for subsequent response monitoring of the axilla. A considerable distinction in metabolic activity was observed between the different subtypes of breast cancer. The mean SUVmax in lymph node metastases of oestrogen receptor ER-positive, triple-negative and human epidermal growth factor receptor 2 HER2-positive tumours was 6.6, 11.6 and 6.6, respectively.

ConclusionThe high accuracy in visualizing lymph node metastases and the sufficiently high SUVmax and tumour to background ratio at baseline suggest that it is feasible to monitor the axillary response with FDG PET-CT, especially in triple-negative tumours.

KeywordsBreast cancer Axillary lymph node metastasis FDG-PET-CT Neoadjuvant chemotherapy  Download fulltext PDF

Autor: Marieke E. Straver - Tjeerd S. Aukema - Renato A. Valdes Olmos - Emiel J. T. Rutgers - Kenneth G. A. Gilhuijs - Marga

Fuente: https://link.springer.com/

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