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Comparison of diffusion-weighted MR imaging and FDG PET/CT to predict pathological complete response to neoadjuvant chemotherapy in patients with breast cancer

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Abstract

Objective

To compare the use of diffusion-weighted MR imaging (DWI) and 18F-FDG PET/CT to predict pathological complete response (pCR) in breast cancer patients receiving neoadjuvant chemotherapy.

Methods

Thirty-four women with 34 invasive breast cancers underwent DWI and PET/CT before and after chemotherapy and before surgery. The percentage changes in the apparent diffusion coefficient (ADC) and the standardised uptake value (SUV) were calculated, and the diagnostic performances for predicting pCR were evaluated using receiver operating characteristic (ROC) curve analysis.

Results

After surgery, 7/34 patients (20.6%) were found to have pCR. A z values for DWI, PET/CT and the combined use of DWI and PET/CT were 0.910, 0.873 and 0.944, respectively. The best cut-offs for differentiating pCR from non-pCR were a 54.9% increase in the ADC and a 63.9% decrease in the SUV. DWI showed 100% (7/7) sensitivity and 70.4% (19/27) specificity and PET/CT showed 100% sensitivity and 77.8% (21/27) specificity. When DWI and PET/CT were combined, there was a trend towards improved specificity compared with DWI.

Conclusions

DWI and FDG PET/CT show similar diagnostic accuracy for predicting pCR to neoadjuvant chemotherapy in breast cancer patients. The combined use of DWI and FDG PET/CT has the potential to improve specificity in predicting pCR.

Key Points

• DWI breast MR and PET/CT show similar accuracy for predicting pathological response

• The combined use of DWI and PET/CT can potentially improve specificity

• This can assist individualised treatment in breast cancer patients receiving neoadjvant chemotherapy

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Acknowledgements

This study was supported by a grant from the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A070001) and by a grant from the Innovative Research Institute for Cell Therapy, Republic of Korea (A062260).

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Hospital, 28 Yongon-Dong, Chongno-Gu, Seoul, 110-744, South Korea

    Sang Hee Park, Woo Kyung Moon, Nariya Cho & Jung Min Chang

  2. Department of Internal Medicine, Seoul National University Hospital, 28 Yongon-Dong, Chongno-Gu, Seoul, 110-744, South Korea

    Seock-Ah Im

  3. Department of Pathology, Seoul National University Hospital, 28 Yongon-Dong, Chongno-Gu, Seoul, 110-744, South Korea

    In Ae Park

  4. Department of Nuclear Medicine, Seoul National University Hospital, 28 Yongon-Dong, Chongno-Gu, Seoul, 110-744, South Korea

    Keon Wook Kang

  5. Department of Surgery, Seoul National University Hospital, 28 Yongon-Dong, Chongno-Gu, Seoul, 110-744, South Korea

    Wonshik Han & Dong-Young Noh

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  1. Sang Hee Park
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Correspondence to Woo Kyung Moon.

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Park, S.H., Moon, W.K., Cho, N. et al. Comparison of diffusion-weighted MR imaging and FDG PET/CT to predict pathological complete response to neoadjuvant chemotherapy in patients with breast cancer. Eur Radiol 22, 18–25 (2012). https://doi.org/10.1007/s00330-011-2236-x

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  • DOI: https://doi.org/10.1007/s00330-011-2236-x

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