Fluorine-18 FDG PET/CT and New NIMS Grading System for Chemotherapy Response in Breast Cancer.

IF 0.4 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Indian Journal of Nuclear Medicine Pub Date : 2024-03-01 Epub Date: 2024-05-29 DOI:10.4103/ijnm.ijnm_117_23
Geethika Reddy Vakati, Ranganath Ratnagiri, Madhur Kumar Srivastava
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引用次数: 0

Abstract

Background: Positron emission tomography with computed tomography (PET-CT) using fluorine 18-fluorodeoxyglucose (F-18 FDG) is increasingly used to stage patients with locally advanced breast cancer and for assessing treatment response after neoadjuvant chemotherapy (NACT).

Aims and objectives: The aim of the study was to assess the correlation between PET-CT parameters and pathologic response of breast primary after NACT in breast cancer patients and to devise a grading system called NIMS grading system for response assessment using PET quantitative parameters.

Materials and methods: 55 patients who underwent F-18 FDG PET-CT before starting the therapy and again after completion of therapy were identified and included in the study. The clinical data and the histopathologic findings were recorded. All the patients received chemotherapy followed by surgery with axillary lymph node dissection. The PET-CT results were interpreted both qualitatively by visual analysis and quantitatively by estimating maximum Standardized uptake values(SUVmax) and other parameters - SUVmean, SUL, SUVBSA, Metabolic tumor volume (MTV) and Total lesion glycolysis (TLG).

Results: The sensitivity and specificity of F-18 FDG PET-CT to detect the residual disease after neoadjuvant chemotherapy was 75.6% & 92.8% respectively. Differences between complete response and residual disease were significant for ΔSUVmax(p=0.005), ΔSUVmean(p=0.006), ΔSUL (0.005) and ΔSUVBSA(0.004), while ΔMTV and ΔTLG were not significantly different between the two groups. The new NIMS grading system included scoring of ΔSUVmax, ΔSUVBSA, ΔTLG and ΔMTV on scale of 1 to 4 and correlated well with PERCIST criteria.

Conclusion: F-18 FDG PET-CT had a good accuracy in the detection of residual disease after completion of NACT. Pre chemotherapy PET-CT is not adequate to predict the response of primary tumour to chemotherapy. However, changes in the values of various PET-CT parameters are a sensitive tool to assess the response to chemotherapy. The new grading system is easy to use and showed good correlation to PERCIST.

氟-18 FDG PET/CT 和新的 NIMS 乳腺癌化疗反应分级系统
背景:使用氟18-脱氧葡萄糖(F-18 FDG)的正电子发射计算机断层扫描(PET-CT)越来越多地用于对局部晚期乳腺癌患者进行分期,以及评估新辅助化疗(NACT)后的治疗反应:该研究旨在评估 PET-CT 参数与乳腺癌患者 NACT 后乳腺原发病理反应之间的相关性,并利用 PET 定量参数设计一套用于反应评估的分级系统,即 NIMS 分级系统。研究记录了临床数据和组织病理学结果。所有患者都接受了化疗,随后进行了腋窝淋巴结清扫手术。PET-CT 结果通过肉眼分析进行定性分析,并通过估算最大标准化摄取值(SUVmax)和其他参数(SUVmean、SUL、SUVBSA、代谢肿瘤体积(MTV)和病变总糖酵解(TLG))进行定量分析:F-18 FDG PET-CT 检测新辅助化疗后残留疾病的敏感性和特异性分别为 75.6% 和 92.8%。完全反应和残留疾病在ΔSUVmax(P=0.005)、ΔSUVmean(P=0.006)、ΔSUL(0.005)和ΔSUVBSA(0.004)方面差异显著,而ΔMTV和ΔTLG在两组间差异不显著。新的 NIMS 分级系统包括对 ΔSUVmax、ΔSUVBSA、ΔTLG 和 ΔMTV 进行 1 至 4 级评分,并与 PERCIST 标准密切相关:结论:F-18 FDG PET-CT 在检测完成 NACT 后的残留疾病方面具有良好的准确性。化疗前 PET-CT 不足以预测原发肿瘤对化疗的反应。然而,PET-CT 各项参数值的变化是评估化疗反应的灵敏工具。新的分级系统易于使用,并与 PERCIST 显示出良好的相关性。
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来源期刊
Indian Journal of Nuclear Medicine
Indian Journal of Nuclear Medicine RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
0.70
自引率
0.00%
发文量
46
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