Article Figures & Data
Figures
- FIGURE 1.
Time–activity curve for primary breast malignancy in representative patient. 18F-fluciclovine uptake was rapid, peaking at 5–10 min, and then slowly decreased until 30 min.
- FIGURE 2.
Reduction in 18F-fluciclovine avidity after neoadjuvant therapy in 52-y-old woman with grade 2 ER−/HER2+ IDC. (A–C) Axial 18F-fluciclovine PET (A), axial CT (B), and axial fused (C) images at baseline show 18F-fluciclovine–avid primary breast mass (solid arrow) and 18F-fluciclovine–avid axillary node metastases (broken arrow). (D–F) Axial 18F-fluciclovine PET (D), axial CT (E), and axial fused (F) images after neoadjuvant therapy show decrease in 18F-fluciclovine avidity of all lesions to background levels. Pathology revealed complete pathologic response, with no residual tumor.
- FIGURE 3.
Scatterplot of percentage of change in corrected SUVmax vs. percentage of tumor volume reduction on pathology after neoadjuvant therapy. ρ = Spearman ρ.
Tables
Characteristic n % Sex (women) 24 100 Race White 18 75 Black 4 16.7 Asian 1 4.2 Hispanic 1 4.2 Histology IDC 18 75 ILC 6 25 Histologic grade Low 1 4.2 Intermediate 8 33.3 High 15 62.5 AJCC tumor stage* 2B 13 54.2 3A 5 20.8 3B 4 16.7 3C 2 8.3 Receptor status (ER+ or PR+)/HER2− 11 45.8 HER2+ 7 29.2 Triple negative (ER−PER−HER2−) 6 25 ↵* Clinical classification according to seventh edition of AJCC Cancer Staging Manual (31).
AJCC = American Joint Committee on Cancer; PR = progesterone receptor.
- TABLE 2
Numbers of Patients with 18F-Fluciclovine–Avid Breast and Node Lesions and 18F-Fluciclovine Avidity Measurements
Lesion No. of patients Parameter Before therapy After therapy* Primary 24 Corrected SUVmax 5.5 (1.4–15.5) 0.1 (0.0–4.3) Corrected SUVmax 2.5 (1.1–6.0) 0.1 (0.0–2.2) MTV 15.7 (3.2–63.9) 1.3 (0.0–26.3) TLA 55.7 (5.0–371) 1.0 (0.0–78.4) Axillary lymph node 19 Corrected SUVmax 4.9 (0.6–13.2) 0.0 (0.0–2.6) Corrected SUVmax 2.2 (0.5–6.2) 0.0 (0.0–1.3) MTV 4.1 (1.0–22.1) 0.0 (0.0–11.3) TLA 10.9 (1.0–137) 0.0 (0.0–15.0) Extraaxillary lymph node 3 Corrected SUVmax 2.0 (1.4–3.2) 0.0 (0.0–0.4) Corrected SUVmax 1.2 (1.0–2.3) 0.0 (0.0–0.0) MTV 1.4 (1.1–1.8) 0.0 (0.0–2.5) TLA 3.2 (2.0–4.6) 0.0 (0.0–2.5) ↵* On scans after neoadjuvant therapy, breast lesions in 12 of 24 patients, axillary node lesions in 14 of 19 patients, and extraaxillary node lesions in 2 of 3 patients decreased to background levels. Lesions that decreased to background levels had corrected SUVmax (as well as SUVmean, MTV [in cm3], and TLA) of 0.
Data are reported as medians, with ranges in parentheses.
- TABLE 3
Correlation Between Percentage of Change in Corrected SUVmax of Primary Malignancy and Percentage of Reduction in Tumor Burden on Pathology After Neoadjuvant Therapy
Change/reduction Parameter SUVmax Pathology ρ P Median −99% −92% 0.79 <0.001 Range −33% to −100% −10% to −100% Patients with reduction to background level Percentage of reduction Tumor characteristic No. of patients n % Median Range Histology IDC 18 10 55.6 100.0 100.0–38.7 ILC 6 2 33.3 70.0 100.0–32.8 Receptor status ER+/HER2− 11 4 36.4 74.1 100.0–32.8 HER2+ 7 5 71.4 100.0 100.0–44.7 Triple negative 6 3 50 98.8 100.0–67.4 Histologic grade 1 or 2 9 3 33.3 74.1 100.0–32.8 3 15 9 60 100.0 100.0–38.7
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