Early prediction of response to neoadjuvant chemotherapy in breast cancer patients: comparison of single-voxel 1H-magnetic resonance spectroscopy and 18F-fluorodeoxyglucose positron emission tomography

Nariya Cho, Seock Ah Im, Keon Wook Kang, In Ae Park, In Chan Song, Kyung Hun Lee, Tae Yong Kim, Hyunjong Lee, In Kook Chun, Hai Jeon Yoon, Woo Kyung Moon

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15 Scopus citations

Abstract

Objectives: To prospectively compare performances of single-voxel proton magnetic resonance spectroscopy (1H-MRS) and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in predicting pathologic response to neoadjuvant chemotherapy (NAC) in breast cancer patients. Methods: Thirty-five breast cancer patients who received NAC and subsequent surgery were prospectively enrolled. MRS and FDG-PET were performed before and after the 1st NAC cycle. Percentage changes of total choline-containing compounds (tCho) via MRS, and maximum and peak standardized uptake values (SUVmax, SUVpeak) and total lesion glycolysis (TLG) via FDG-PET were measured, and their performances in predicting pathologic complete response (pCR) were compared. Results: Of the 35 patients, 6 showed pCR and 29 showed non-pCR. Mean % reductions of tCho, SUVmax, SUVpeak, and TLG of the pCR group were larger than those of the non-pCR group (-80.3 ± 13.9 % vs. -32.1 ± 49.4 %, P = 0.025; -54.7 ± 22.1 % vs. -26.3 ± 33.7 %, P = 0.058; -60.7 ± 18.3 % vs. -32.3 ± 23.3 %, P = 0.009; -89.5 ± 8.5 % vs. -52.6 ± 36.2 %, P = 0.020). Diagnostic accuracy (area under ROC curve; Az, 0.911) of the % reduction of tCho was comparable to those of %SUVmax (0.822), SUVpeak (0.862), and TLG (0.879) in distinguishing pCR from non-pCR (all P > 0.05). Conclusion: MRS showed comparable performance to FDG-PET in early prediction of pCR in breast cancer patients. Key points: • MRS can predict response to NAC in breast cancer post-1stcycle. • Changes in tCho and SUV after NAC reflect tumour cellularity changes. • MRS can be an alternative to FDG-PET in predicting response to NAC.

Original languageEnglish
Pages (from-to)2279-2290
Number of pages12
JournalEuropean Radiology
Volume26
Issue number7
DOIs
StatePublished - 1 Jul 2016

Bibliographical note

Funding Information:
The scientific guarantor of this publication is Woo Kyung Moon. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2014R1A1A2053682), and by a grant (no. 03-2014-0320) from the Seoul National University Hospital Research Fund, and the Korea Healthcare Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (grant A070001). Some patients have been reported previously in Breast Cancer: Early Prediction of Response to Neoadjuvant Chemotherapy Using Parametric Response Maps for MR Imaging. Radiology 2014;272:385-396. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, diagnostic or prognostic study, performed at one institution.

Publisher Copyright:
© 2015, European Society of Radiology.

Keywords

  • Breast neoplasm
  • Magnetic resonance imaging
  • Magnetic resonance spectroscopy
  • Neoadjuvant chemotherapy
  • Positron emission tomography

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