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Prediction of pathological complete response after neoadjuvant chemotherapy in breast cancer: comparison of diagnostic performances of dedicated breast PET, whole-body PET, and dynamic contrast-enhanced MRI

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Abstract

Purpose

To compare the diagnostic performance of ring-type dedicated breast PET (dbPET), whole-body PET (WBPET), and DCE-MRI for predicting pathological complete response (pCR) after neoadjuvant chemotherapy (NAC).

Methods

This prospective study included 29 women with histologically proven breast cancer on needle biopsy between July 2016 and July 2019 (age: mean 55 years; range 35–78). Patients underwent WBPET followed by ring-type dbPET and DCE-MRI pre- and post-NAC for preoperative evaluation. pCR was defined as an invasive tumor that disappeared in the breast. Standardized uptake values corrected for lean body mass (SULpeak) were calculated for dbPET and WBPET scans. Maximum tumor length was measured in DCE-MRI images.

Reduction rates were calculated for quantitative evaluation. Two radiologists independently evaluated the qualitative findings. Reduction rates and qualitative findings were compared between the pCR (n = 7) and non-pCR (n = 22) groups for each modality. Differences in quantitative and qualitative data between the two groups were analyzed statistically.

Results

Significant differences were observed in the reduction rates of dbPET and DCE-MRI (P = 0.01 and 0.03, respectively) between the two groups. Univariate and multiple logistic regression analyses revealed that SULpeak reduction rates in WBPET and dbPET (P = 0.02 and P = 0.01, respectively) and in dbPET (odds ratio, 16.00; 95% CI 1.57–162.10; P = 0.01) were significant indicators associated with pCR, respectively. No between-group differences were observed in qualitative findings in the three modalities.

Conclusion

SULpeak reduction rate of dbPET > 82% was an independent indicator associated with pCR after NAC in breast cancer.

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Acknowledgements

The authors declare no conflicts of interest associated with this manuscript. We thank Mamoru Furuyashiki, RT, Akira Kida, RT, Risa Momoi, RT, and Shima Inoue, RT, for examination of patients with WBPET and dbPET in the MI Clinic and for support with the measurement of quantitative data. We would like to thank Editage (www.editage.com) for English language editing.

Author information

Author notes

  1. Keiichiro Honma

    Present address: Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka city, Osaka, 541-8567, Japan

Authors and Affiliations

  1. Department of Radiology, Osaka University Graduate School of Medicine, 2–2 Yamadaoka, Suita-shi, Osaka, 565–0871, Japan

    Yukiko Tokuda, Masahiro Yanagawa, Yuka Fujita & Noriyuki Tomiyama

  2. Department of Pathology, Osaka University Graduate School of Medicine, 2–2 Yamadaoka, Suita-shi, Osaka, 565–0871, Japan

    Keiichiro Honma

  3. Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, 2–2 Yamadaoka, Suita-shi, Osaka, 565–0871, Japan

    Tomonori Tanei, Masafumi Shimoda, Tomohiro Miyake, Yasuto Naoi, Seung Jin Kim & Kenzo Shimazu

  4. MI Clinic, 1-12-13 Shoji, Toyonaka-shi, Osaka, 560–0004, Japan

    Seiki Hamada

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  1. Yukiko Tokuda
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Tokuda, Y., Yanagawa, M., Fujita, Y. et al. Prediction of pathological complete response after neoadjuvant chemotherapy in breast cancer: comparison of diagnostic performances of dedicated breast PET, whole-body PET, and dynamic contrast-enhanced MRI. Breast Cancer Res Treat 188, 107–115 (2021). https://doi.org/10.1007/s10549-021-06179-7

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