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首页> 外文期刊>European Journal of Nuclear Medicine and Molecular Imaging >FDG PET evaluation of early axillary lymph node response to neoadjuvant chemotherapy in stage II and III breast cancer patients.
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FDG PET evaluation of early axillary lymph node response to neoadjuvant chemotherapy in stage II and III breast cancer patients.

机译：FDG PET评估II和III期乳腺癌患者对新辅助化疗的早期腋窝淋巴结反应。

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PURPOSE: Regional axillary lymph node status has remained the single most independent variable to predict prognosis both in terms of disease recurrence and survival. This study aimed to prospectively assess sequential [(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET) findings as early predictors of axillary lymph node response to neoadjuvant chemotherapy in stage II and III breast cancer patients. METHODS: Images were acquired with a PET/CT scanner in 52 patients after administration of FDG (5 MBq/kg) at baseline and after the first, second, third and sixth course of chemotherapy before surgery. Clinical examination and ultrasound (US) were used to assess the size of axillary nodes. Decrease in the standardized uptake value (SUV) with PET corrected or not for partial volume effects was compared to the pathological response. RESULTS: The sensitivity, specificity and accuracy of axillary node staging was higher with PET (75, 87 and 80%) than with US (50, 83 and 65%), and even more so when PET images were corrected for partial volume effects (86, 83 and 84%). While FDG uptake did not vary much in non-responders, as confirmed by histopathological analysis, it markedly decreased to baseline levels in responders (p < 10(-5)). Fifty per cent of baseline SUV was considered the best cutoff value to distinguish responders from non-responders. The sensitivity, specificity, negative predictive value and accuracy of FDG PET after one course of chemotherapy were, respectively, 96, 75, 95 and 84%. CONCLUSION: The pathological status of regional axillary lymph nodes in stage II and III breast cancer patients could be accurately predicted after one course of neoadjuvant chemotherapy based on FDG PET images.
机译：目的：区域腋窝淋巴结状态一直是预测疾病复发和生存的最独立变量。这项研究旨在前瞻性评估顺序[[18] F]氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）研究结果，作为II和III期乳腺癌患者对新辅助化疗的腋窝淋巴结反应的早期预测指标。方法：在基线时施用FDG（5 MBq / kg）后以及术前进行第一，第二，第三和第六疗程的化疗后，使用PET / CT扫描仪对52例患者进行了图像采集。临床检查和超声检查（US）用于评估腋窝淋巴结的大小。将针对部分体积效应校正或未校正的PET的标准摄取值（SUV）降低与病理反应进行比较。结果：PET（75％，87％和80％）的腋窝淋巴结分期的敏感性，特异性和准确性均高于US（50％，83％和65％），当校正PET图像的部分容积效应时更是如此（ 86、83和84％）。组织病理学分析证实，尽管非应答者的FDG摄取变化不大，但应答者的FDG摄取显着下降至基线水平（p <10（-5））。基准SUV的百分之五十被认为是区分响应者和非响应者的最佳临界值。一疗程化疗后FDG PET的敏感性，特异性，阴性预测值和准确性分别为96％，75％，95％和84％。结论：根据FDG PET图像，经过一疗程的新辅助化疗，可以准确预测II期和III期乳腺癌患者局部腋窝淋巴结的病理状态。

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