18F-FDG 专用乳腺 PET 与乳腺 MRI 相辅相成，用于评估新辅助化疗的早期反应。

IF 5.6 Q1 ONCOLOGY

Radiology. Imaging cancer Pub Date : 2024-03-01 DOI:10.1148/rycan.230082

Devan Diwanji, Natsuko Onishi, Deep K Hathi, Courtney Lawhn-Heath, John Kornak, Wen Li, Ruby Guo, Julissa Molina-Vega, Youngho Seo, Robert R Flavell, Diane Heditsian, Susie Brain, Laura J Esserman, Bonnie N Joe, Nola M Hylton, Ella F Jones, Kimberly M Ray

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FDG dbPET-derived standardized uptake value (SUV), metabolic tumor volume, and total lesion glycolysis (TLG) and MRI-derived percent enhancement (PE), signal enhancement ratio (SER), and functional tumor volume (FTV) were calculated at both time points. Differences between FDG dbPET and MRI parameters were evaluated after stratifying by receptor status, Ki-67 index, and residual cancer burden. Parameters were compared using Wilcoxon signed rank and Mann-Whitney U tests. Results High Ki-67 tumors had higher baseline SUVmean (difference, 5.1; P = .01) and SUVpeak (difference, 5.5; P = .04). At T1, decreases were observed in FDG dbPET measures (pseudo-median difference T0 minus T1 value [95% CI]) of SUVmax (-6.2 [-10.2, -2.6]; P < .001), SUVmean (-2.6 [-4.9, -1.3]; P < .001), SUVpeak (-4.2 [-6.9, -2.3]; P < .001), and TLG (-29.1 mL3 [-71.4, -6.8]; P = .005) and MRI measures of SERpeak (-1.0 [-1.3, -0.2]; P = .02) and FTV (-11.6 mL3 [-22.2, -1.7]; P = .009). 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引用次数: 0

摘要

目的比较新辅助化疗（NAC）早期治疗期间使用氟18（18F）脱氧葡萄糖（FDG）专用乳腺PET（dbPET）和乳腺动态对比增强（DCE）MRI对肿瘤代谢和灌注进行的定量测量。材料与方法对 20 名患有 22 例浸润性乳腺癌的患者在基线（T0）和接受新辅助化疗 3 周后（T1）进行的前瞻性 DCE MRI 和 18F-FDG dbPET 检查进行分析。在这两个时间点计算了 FDG dbPET 导出的标准化摄取值 (SUV)、代谢肿瘤体积和总病变糖酵解 (TLG)，以及 MRI 导出的增强百分比 (PE)、信号增强比 (SER) 和功能性肿瘤体积 (FTV)。根据受体状态、Ki-67 指数和残留癌负荷进行分层后，评估 FDG dbPET 和 MRI 参数之间的差异。参数比较采用 Wilcoxon 符号秩检验和 Mann-Whitney U 检验。结果高 Ki-67 肿瘤的基线 SUVmean 值（差异为 5.1；P = .01）和 SUVpeak 值（差异为 5.5；P = .04）较高。在 T1 期，观察到 FDG dbPET 测量值（伪中位数差异 T0 减 T1 值 [95% CI]）SUVmax（-6.2 [-10.2, -2.6]; P < .001）、SUVmean（-2.6 [-4.9, -1.3]; P < .001), SUVpeak (-4.2 [-6.9, -2.3]; P < .001), and TLG (-29.1 mL3 [-71.4, -6.8]; P = .005) and MRI measures of SERpeak (-1.0 [-1.3, -0.2]; P = .02) and FTV (-11.6 mL3 [-22.2, -1.7]; P = .009)。与非反应性肿瘤相比，反应性肿瘤的 SUVmax 百分比变化差异（95% CI）为-34.3%（-55.9%，1.5%；P = .06），PEpeak 百分比变化差异为-42.4%（95% CI：-110.5%，8.5%；P = .08）。结论 18F-FDG dbPET 对 NAC 期间的早期变化很敏感，并能提供 DCE MRI 的补充信息，可能对治疗反应评估有用。关键词乳腺正电子发射动态对比增强磁共振成像临床试验注册号本文有补充材料。© RSNA, 2024.

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¹⁸F-FDG Dedicated Breast PET Complementary to Breast MRI for Evaluating Early Response to Neoadjuvant Chemotherapy.

Purpose To compare quantitative measures of tumor metabolism and perfusion using fluorine 18 (¹⁸F) fluorodeoxyglucose (FDG) dedicated breast PET (dbPET) and breast dynamic contrast-enhanced (DCE) MRI during early treatment with neoadjuvant chemotherapy (NAC). Materials and Methods Prospectively collected DCE MRI and ¹⁸F-FDG dbPET examinations were analyzed at baseline (T0) and after 3 weeks (T1) of NAC in 20 participants with 22 invasive breast cancers. FDG dbPET-derived standardized uptake value (SUV), metabolic tumor volume, and total lesion glycolysis (TLG) and MRI-derived percent enhancement (PE), signal enhancement ratio (SER), and functional tumor volume (FTV) were calculated at both time points. Differences between FDG dbPET and MRI parameters were evaluated after stratifying by receptor status, Ki-67 index, and residual cancer burden. Parameters were compared using Wilcoxon signed rank and Mann-Whitney U tests. Results High Ki-67 tumors had higher baseline SUV_mean (difference, 5.1; P = .01) and SUV_peak (difference, 5.5; P = .04). At T1, decreases were observed in FDG dbPET measures (pseudo-median difference T0 minus T1 value [95% CI]) of SUV_max (-6.2 [-10.2, -2.6]; P < .001), SUV_mean (-2.6 [-4.9, -1.3]; P < .001), SUV_peak (-4.2 [-6.9, -2.3]; P < .001), and TLG (-29.1 mL³ [-71.4, -6.8]; P = .005) and MRI measures of SER_peak (-1.0 [-1.3, -0.2]; P = .02) and FTV (-11.6 mL³ [-22.2, -1.7]; P = .009). Relative to nonresponsive tumors, responsive tumors showed a difference (95% CI) in percent change in SUV_max of -34.3% (-55.9%, 1.5%; P = .06) and in PE_peak of -42.4% (95% CI: -110.5%, 8.5%; P = .08). Conclusion ¹⁸F-FDG dbPET was sensitive to early changes during NAC and provided complementary information to DCE MRI that may be useful for treatment response evaluation. Keywords: Breast, PET, Dynamic Contrast-enhanced MRI Clinical trial registration no. NCT01042379 Supplemental material is available for this article. © RSNA, 2024.

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来源期刊

Radiology. Imaging cancer

CiteScore

5.00

自引率

2.30%

发文量