Abstract for presentation at 38th Annual Scientific Meeting of the Australian and New Zealand Society of Nuclear Medicine 2008

FDG PET Imaging to Assess Response to Chemotherapy in Locally Advanced Breast Cancer

  • Dr Roslyn Francis, Sir Charles Gairdner Hospital, Australia
  • Dr Agatha van der Schaaf, Sir Charles Gairdner Hospital, Australia
  • Dr Arlene Chan, Mount Hospital, Australia
  • Dr Peter Robins, Sir Charles Gairdner Hospital, Australia
  • Dr Karen Tucker, Sir Charles Gairdner Hospital, Australia
  • Dr Elizabeth Thomas, Sir Charles Gairdner Hospital, Australia
  • Jan Boucek, Sir Charles Gairdner Hospital, Australia
  • Dr Steven Allpress, Mount Hospital, Australia
  • D Hastrich, Mount Hospital, WA, Australia
  • D Ingram, Mount Hospital, WA, Australia
  • T Barham, Mount Hospital, WA, Australia
  • A Redfern, Royal Perth Hospital, WA, Australia
  • P Willsher, Mount Hospital, WA, Australia

    • Background: There is currently no standard approach to the treatment of locally advanced breast cancer (LABC) in Australia. FDG PET imaging was performed as part of multi-centre clinical trial undertaken to establish assess the feasibility of a uniform approach to the treatment of LABC.
    Methods: Women > 18 years with histologically confirmed LABC underwent FDG PET imaging pre and post 6 cycles of neoadjuvant chemotherapy. Whole body imaging was performed using a Phillips Allegro GSO PET scanner 60 minutes following 370-500MBq FDG. Response assessment was performed using visual and quantitative analysis, incorporating SUVmax and total glycolytic volume (TGV) (Francis et al, JNM 2007). PET response was compared with pathological tumour response.
    Results: 44 patients were prospectively recruited; 38 completed pre and post chemotherapy PET scans. Median age 49ys, range 34-78 years. Pathologically 10 patients had a complete response (tumour and nodes) to chemotherapy. 9 of 18 (50%) complete metabolic responders compared to 1 of 19 (5%) PET partial responders attained a complete pathological response. 90% of the pathological complete responders had a metabolic complete response to chemotherapy. There was a statistically significant difference in the change in SUVmax values of the pathological complete response group compared to partial responders (p=0.005). Change in TGV values of the pathological complete versus partial responders was however not statistically significant (p=0.1).
    Conclusion: The assessment of response to neoadjuvant chemotherapy in LABC using FDG PET imaging is feasible. Metabolic complete responders are more likely to attain a pathological complete response than ‘incomplete’ metabolic responders.

    Conference Organiser - ICMS Pty Ltd