Abstract
The aim of this prospective study was to assess the predictive value of 18F-FDG PET/CT imaging for pathologic response to neoadjuvant chemotherapy (NACT) and outcome in Inflammatory Breast Cancer (IBC) patients. Methods: Twenty-three consecutive patients (51 years±12.7) with newly diagnosed IBC, assessed by PET/CT scan at baseline (PET1), after the third course of NACT (PET2) and before surgery (PET3), were included. Patients were divided into 2 groups according to the pathologic response assessed by the Sataloff classification: pCR for complete responders (TA and NA or NB) and non-pCR for non-complete responders (not stage A for tumor and/or not NA or NB for lymph nodes). In addition to SUVmax measurements, a global breast Metabolic Tumor Volume (MTV) was delineated using a semi-automatic segmentation method. Changes of SUVmax and MTV between PET1 and PET2 (ΔSUV1-2; ΔMTV1-2) and PET1 and PET3 (ΔSUV1-3; ΔMTV1-3) were measured. Results: Mean SUVmax on PET1, PET2 and PET3 were not statistically different between the 2 pathologic response groups. Using ROC analysis, a 72% cutoff of ΔSUV1-3 provided the best performance to predict residual disease with sensitivity, specificity and accuracy of 61%, 80%, and 65%, respectively. On univariate analysis, the 72% cutoff of ΔSUV1-3 was the best predictor of Distant Metastasis-Free Survival (P = 0.05). On multivariate analysis, the 72% cutoff ΔSUV1-3 was an independent predictor of DMFS (P = 0.01). Conclusion: Our results emphasize the good predictive value of ΔSUVmax between baseline and before surgery to assess pathologic response and survival in IBC patients undergoing NACT.
- Breast
- Oncology: Breast
- PET/CT
- 18F-FDG PET/CT
- Inflammatory breast cancer
- Survival
- neoadjuvant chemotherapy
- Copyright © 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.