FDG PET evaluation of early axillary lymph node response to neoadjuvant chemotherapy in stage II and III breast cancer patients View Full Text


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Article Info

DATE

2011-02-10

AUTHORS

Caroline Rousseau, Anne Devillers, Mario Campone, Loïc Campion, Ludovic Ferrer, Christine Sagan, Myriam Ricaud, Boumédiène Bridji, Françoise Kraeber-Bodéré

ABSTRACT

PurposeRegional axillary lymph node status has remained the single most independent variable to predict prognosis both in terms of disease recurrence and survival. This study aimed to prospectively assess sequential [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) findings as early predictors of axillary lymph node response to neoadjuvant chemotherapy in stage II and III breast cancer patients.MethodsImages were acquired with a PET/CT scanner in 52 patients after administration of FDG (5 MBq/kg) at baseline and after the first, second, third and sixth course of chemotherapy before surgery. Clinical examination and ultrasound (US) were used to assess the size of axillary nodes. Decrease in the standardized uptake value (SUV) with PET corrected or not for partial volume effects was compared to the pathological response.ResultsThe sensitivity, specificity and accuracy of axillary node staging was higher with PET (75, 87 and 80%) than with US (50, 83 and 65%), and even more so when PET images were corrected for partial volume effects (86, 83 and 84%). While FDG uptake did not vary much in non-responders, as confirmed by histopathological analysis, it markedly decreased to baseline levels in responders (p < 10−5). Fifty per cent of baseline SUV was considered the best cutoff value to distinguish responders from non-responders. The sensitivity, specificity, negative predictive value and accuracy of FDG PET after one course of chemotherapy were, respectively, 96, 75, 95 and 84%.ConclusionThe pathological status of regional axillary lymph nodes in stage II and III breast cancer patients could be accurately predicted after one course of neoadjuvant chemotherapy based on FDG PET images. More... »

PAGES

1029-1036

References to SciGraph publications

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  • 2002-04-02. Prognostic significance of a complete pathological response after induction chemotherapy in operable breast cancer in BRITISH JOURNAL OF CANCER
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  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00259-011-1735-y

    DOI

    http://dx.doi.org/10.1007/s00259-011-1735-y

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/21308372


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    32 schema:description PurposeRegional axillary lymph node status has remained the single most independent variable to predict prognosis both in terms of disease recurrence and survival. This study aimed to prospectively assess sequential [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) findings as early predictors of axillary lymph node response to neoadjuvant chemotherapy in stage II and III breast cancer patients.MethodsImages were acquired with a PET/CT scanner in 52 patients after administration of FDG (5 MBq/kg) at baseline and after the first, second, third and sixth course of chemotherapy before surgery. Clinical examination and ultrasound (US) were used to assess the size of axillary nodes. Decrease in the standardized uptake value (SUV) with PET corrected or not for partial volume effects was compared to the pathological response.ResultsThe sensitivity, specificity and accuracy of axillary node staging was higher with PET (75, 87 and 80%) than with US (50, 83 and 65%), and even more so when PET images were corrected for partial volume effects (86, 83 and 84%). While FDG uptake did not vary much in non-responders, as confirmed by histopathological analysis, it markedly decreased to baseline levels in responders (p < 10−5). Fifty per cent of baseline SUV was considered the best cutoff value to distinguish responders from non-responders. The sensitivity, specificity, negative predictive value and accuracy of FDG PET after one course of chemotherapy were, respectively, 96, 75, 95 and 84%.ConclusionThe pathological status of regional axillary lymph nodes in stage II and III breast cancer patients could be accurately predicted after one course of neoadjuvant chemotherapy based on FDG PET images.
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    39 FDG
    40 FDG uptake
    41 FDG-PET
    42 FDG-PET evaluation
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    44 MethodsImages
    45 PET
    46 PET evaluation
    47 PET images
    48 PET/CT scanner
    49 ResultsThe sensitivity
    50 accuracy
    51 administration
    52 administration of FDG
    53 analysis
    54 axillary lymph
    55 axillary lymph node status
    56 axillary lymph nodes
    57 axillary node staging
    58 axillary nodes
    59 baseline
    60 baseline levels
    61 baseline standardized uptake value
    62 best cutoff value
    63 breast cancer patients
    64 cancer patients
    65 cent
    66 chemotherapy
    67 clinical examination
    68 course
    69 courses of chemotherapy
    70 cutoff value
    71 disease recurrence
    72 early predictor
    73 effect
    74 evaluation
    75 examination
    76 findings
    77 histopathological analysis
    78 images
    79 independent variables
    80 levels
    81 lymph
    82 lymph node status
    83 lymph nodes
    84 negative predictive value
    85 neoadjuvant chemotherapy
    86 node staging
    87 node status
    88 nodes
    89 partial volume effects
    90 pathological response
    91 pathological status
    92 patients
    93 positron emission tomography findings
    94 predictive value
    95 predictors
    96 prognosis
    97 recurrence
    98 regional axillary lymph nodes
    99 responders
    100 response
    101 scanner
    102 sensitivity
    103 sixth course
    104 size
    105 specificity
    106 stage II
    107 staging
    108 standardized uptake value
    109 status
    110 study
    111 surgery
    112 survival
    113 terms
    114 tomography findings
    115 ultrasound
    116 uptake
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