Predictive value of FDG PET/CT for pathologic axillary node involvement after neoadjuvant chemotherapy

Breast Cancer - Tập 20 - Trang 167-173 - 2012
Bhumsuk Keam1,2, Seock-Ah Im1,2, Youngil Koh1, Sae-Won Han1,2, Do-Youn Oh1,2, Nariya Cho3, Jee Hyun Kim1,2, Wonshik Han4, Keon Wook Kang2,5, Woo Kyung Moon3, Tae-You Kim1,2, In Ae Park6, Dong-Young Noh4, June-Key Chung2,5, Yung-Jue Bang1,2
1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
2Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
3Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
4Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
5Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
6Department of Pathology, Seoul National University College of Medicine, Seoul, Korea

Tóm tắt

The purpose of this study was to determine the usefulness of sequential FDG PET/CTs for prediction of axillary lymph node (ALN) status after neoadjuvant chemotherapy (NAC). Seventy-seven stage II or III breast cancer patients who received 3 cycles of neoadjuvant docetaxel/doxorubicin chemotherapy were enrolled in this prospective study. FDG PET/CTs were acquired before chemotherapy and after the first cycle of chemotherapy for early metabolic response prediction. Patients with pN0 had significantly lower post-NAC ALN standard uptake value (SUV) than those who were pN+ (1.22 ± 1.46 in pN0 vs. 2.13 ± 1.99 in pN+, P = 0.017). Post-NAC ALN size on CT also differed according to pathologic ALN status (6.3 mm in pN0 vs. 11.1 mm in pN+, P = 0.014). When serial FDG PET/CT and chest CT were used, patients with an SUV > 1.5 and post-NAC ALN size ≥10 mm on CT did not achieve pN0 (specificity 100% and positive predictive value 100%). The serial FDG PET/CT after NAC could predict the pathologic status of ALN before surgery in stage II/III breast cancer. Our findings suggest that the combined use of serial FDG PET/CTs and chest CT might provide better information regarding ALN before surgery.

Tài liệu tham khảo

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