RT Journal Article SR Electronic T1 18F-FDG PET–Derived Tumor Blood Flow Changes After 1 Cycle of Neoadjuvant Chemotherapy Predicts Outcome in Triple-Negative Breast Cancer JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 1707 OP 1712 DO 10.2967/jnumed.116.172759 VO 57 IS 11 A1 Olivier Humbert A1 Jean-Marc Riedinger A1 Jean-Marc Vrigneaud A1 Salim Kanoun A1 Inna Dygai-Cochet A1 Alina Berriolo-Riedinger A1 Michel Toubeau A1 Edouard Depardon A1 Maud Lassere A1 Simon Tisserand A1 Pierre Fumoleau A1 François Brunotte A1 Alexandre Cochet YR 2016 UL http://jnm.snmjournals.org/content/57/11/1707.abstract AB Previous studies have suggested that early changes in blood flow (BF) in response to neoadjuvant chemotherapy and evaluated with 15O-water are a surrogate biomarker of outcome in women with breast cancer. This study investigates, in the triple-negative breast cancer subtype, the prognostic relevance of tumor BF changes (ΔBF) in response to chemotherapy, assessed using a short dynamic 18F-FDG PET acquisition. Methods: Forty-six consecutive women with triple-negative breast cancer and an indication for neoadjuvant chemotherapy were prospectively included. Women benefited from a baseline 18F-FDG PET examination with a 2-min chest-centered dynamic acquisition, started at the time of 18F-FDG injection. Breast tumor perfusion was calculated from this short dynamic image using a first-pass model. This dynamic PET acquisition was repeated after the first cycle of chemotherapy to measure early ΔBF. Delayed static PET acquisitions were also performed (90 min after 18F-FDG injection) to measure changes in tumor glucose metabolism (ΔSUVmax). The association between tumor BF, clinicopathologic characteristics, and patients’ overall survival (OS) was evaluated. Results: Median baseline tumor BF was 21 mL/min/100 g (range, 6–46 mL/min/100 g) and did not significantly differ according to tumor size, Scarf–Bloom–Richardson grade, or Ki-67 expression. Median tumor ∆BF was −30%, with highly scattered values (range, −93% to +118%). A weak correlation was observed between ΔBF and ∆SUVmax (r = +0.40, P = 0.01). The median follow-up was 30 mo (range, 6–73 mo). Eight women developed recurrent disease, 7 of whom died. Low OS was associated with menopausal history (P = 0.03), persistent or increased tumor vascularization on the interim PET (ΔBF cutoff = −30%; P = 0.03), non–breast-conserving surgery (P = 0.04), and the absence of a pathologic complete response (pCR) (P = 0.01). ΔBF and pCR provided incremental prognostic stratification: 3-y OS was 100% in pCR women, 87% in no-pCR women but achieving an early tumor BF response, and only 48% in no-pCR/no-BF–response women (ΔBF cutoff = −30%, P < 0.001). Conclusion: This study suggests the clinical usefulness of an early user- and patient-friendly 2-min dynamic acquisition to monitor breast tumor ΔBF to neoadjuvant chemotherapy using 18F-FDG PET/CT. Monitoring tumor perfusion and angiogenesis response to treatment seems to be a promising target for PET tracers.