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Glycolytic activity with 18F-FDG PET/CT predicts final neoadjuvant chemotherapy response in breast cancer

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Tumor Biology

Abstract

The purpose of the present study is to explore the relation between glycolytic metabolism assessed by 18F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) and final neoadjuvant chemotherapy (NC) response in locally advanced breast tumors. Of women with breast cancer, 126 were prospectively evaluated. All patients underwent 18F-FDG PET/CT previous to NC. Standard uptake value (SUV) max was calculated in the primary tumor. After NC, residual primary tumor specimen was histopathologically classified according to Miller and Payne tumor regression grades (TRG), from G1 to G5 and in response groups as good responders (G4 or G5), partial responders (G2 or G3), and non-responders (G1). Furthermore, residual lesions were classified following a binary assessment as responders (G4 or G5) and non-responders (the rest of cases). The relationship between SUV max with TRG and response groups was evaluated. Of tumors, 127 were assessed (a patient had bilateral breast lesions). TRG were as follows: G1 (27), G2 (27), G3 (32), G4 (11), and G5 (30). Forty-one were classified as good responders, 59 as partial responders, and 27 as non-responders. For the binary assessment, 41 lesions were classified as responders and 86 as non-responders. We found statistical differences (p = 0.02) between the mean SUV max and TRG with greater SUV values for G5 compared to the other TRG. Good responders showed greater mean SUV max ± SD compared to partial responders and non-responders (10.51 ± 6.64 for good responders, 6.94 ± 5.81 for partial responders, and 5.23 ± 2.76 for non-responders; p = 0.001). Baseline tumor metabolism assessing by FDG PET/CT was associated with the final histopathologic status after neoadjuvant chemotherapy, with greater SUV max values for good responders compared to the less responder cancers.

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Authors and Affiliations

  1. Nuclear Medicine Department, University General Hospital, C/ Obispo Rafael Torija s/n, 13005, Ciudad Real, Spain

    Ana María García Vicente, Ober Van Gómez López & Ángel Soriano Castrejón

  2. Oncology Department, Virgen de la Salud Hospital, Toledo, Spain

    Miguel Ángel Cruz Mora

  3. Investigation Unit, University General Hospital, Ciudad Real, Spain

    Antonio Alberto León Martín

  4. Oncology Department, Virgen de la Luz Hospital, Cuenca, Spain

    María del Mar Muñoz Sánchez

  5. Pathology Department, University General Hospital, Ciudad Real, Spain

    Fernanda Relea Calatayud

  6. Oncology Department, La Mancha Centro Hospital, Alcazar, Ciudad Real, Spain

    Ruth Espinosa Aunión

  7. Oncology Department, Ntra. Sra. del Prado Hospital, Talavera, Toledo, Spain

    Ana Gonzalez Ageitos

Authors
  1. Ana María García Vicente
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  2. Miguel Ángel Cruz Mora
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  3. Antonio Alberto León Martín
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  4. María del Mar Muñoz Sánchez
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  5. Fernanda Relea Calatayud
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  6. Ober Van Gómez López
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  7. Ruth Espinosa Aunión
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  8. Ana Gonzalez Ageitos
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  9. Ángel Soriano Castrejón
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Correspondence to Ana María García Vicente.

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García Vicente, A.M., Cruz Mora, M.Á., León Martín, A.A. et al. Glycolytic activity with 18F-FDG PET/CT predicts final neoadjuvant chemotherapy response in breast cancer. Tumor Biol. 35, 11613–11620 (2014). https://doi.org/10.1007/s13277-014-2495-7

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  • DOI: https://doi.org/10.1007/s13277-014-2495-7

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