Role of 18 FDG PET/CT Imaging in Assessment of Neoadjuvant Chemotherapy Response in Breast Cancer Patients

Abstract

ositron emission tomography (PET) with 18 fluorine (18f) flurodeoxy glucose (FDG) has an important role in oncology. Its role in management of breast cancer is evolving recently. Imaging of metabolic pathways serves as an alternative way for visualizing the treatment effects; furthermore, metabolic reduction within the tumor precedes the anatomic response to therapy. PET with 18 F- FDG has been used to evaluate the clinical response to NAC in patient with breast cancer. The 18F-FDG uptake, expressed semiquantitatively by standardized uptake value (SUV), that has been reported as a strong predictor of clinical and pathologic response. PET CT allows the assessment of metabolic changes in residual tumor cells rather than just morphological changes; which was very beneficial with non-mass forming tumors. In our study we included 30 patients with different breast lesions. All patients had a Pretreatment PET CT examination and post chemotherapy PET CT follow up examination. Finally, the results were compared to the histopathological results. It was found that assessment of NAC therapy response by PET CT had a sensitivity of 95.5%, specificity of 75 % and accuracy of 90% using PERCIST1 system, while CT alone had sensitivity of 81.8%, specificity of 75%and accuracy of 80% using the RECIST1.1 system.