Preliminary experiences of PET/MRI in predicting complete response in patients with breast cancer treated with neoadjuvant chemotherapy

Sekine,Chikako; Uchiyama,Nachiko; Watase,Chikashi; Murata,Takeshi; Shiino,Sho; Jimbo,Kenjiro; Iwamoto,Eriko; Takayama,Shin; Kurihara,Hiroaki; Satomi,Kaishi; Yoshida,Masayuki; Kinoshita,Takayuki; Suto,Akihiko

doi:10.3892/mco.2021.2483

Preliminary experiences of PET/MRI in predicting complete response in patients with breast cancer treated with neoadjuvant chemotherapy

Authors:
- Chikako Sekine
- Nachiko Uchiyama
- Chikashi Watase
- Takeshi Murata
- Sho Shiino
- Kenjiro Jimbo
- Eriko Iwamoto
- Shin Takayama
- Hiroaki Kurihara
- Kaishi Satomi
- Masayuki Yoshida
- Takayuki Kinoshita
- Akihiko Suto
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Affiliations: Department of Breast Surgery, National Cancer Center, Tokyo 104‑0045, Japan, Department of Radiology, National Cancer Center, Tokyo 104‑0045, Japan, Department of Diagnostic Pathology, National Cancer Center, Tokyo 104‑0045, Japan, Department of Breast Surgery, National Hospital Organization Tokyo Medical Center, Tokyo 152‑8902, Japan
Published online on: December 24, 2021 https://doi.org/10.3892/mco.2021.2483
Article Number: 50
Copyright: © Sekine et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Clinical response predictions through image examinations after neoadjuvant chemotherapy (NAC) for breast cancer is important. The present study aimed to evaluate the utility of a novel imaging modality, positron‑emission tomography/magnetic resonance imaging (PET/MRI), in predicting the pathological complete response (pCR) to NAC in patients with early breast cancer. A total of 74 patients underwent PET/MRI, mammography (MG), including tomosynthesis, and ultrasound (US) after NAC. The complete response was predicted using each modality and these outcomes were compared accordingly. In terms of PET/MRI, complete response (CR) was defined as the disappearance of 18F‑fluorodeoxyglucose uptake and the absence of enhanced lesions with contrast enhanced MRI. In MG and US, undetectable lesions were considered as CR. The background and tumor characteristics of patients were also analyzed between the pCR and non‑pCR cases. Overall, 18 (24.3%) of the 74 patients achieved pCR. The overall sensitivity and specificity of PET/MRI were 72.2 and 78.6%, respectively. Both the sensitivity in hormone receptor (HR)‑positive cases and the specificity in HR‑negative cases were 100%. HR‑negative and human epidermal growth factor receptor 2 (HER2)‑positive cases demonstrated a significant association with pCR compared with HR‑positive cases and triple negative cases (P=0.017). Furthermore, patients with ‘mass’ type lesions evaluated by MRI before NAC experienced pCR with a higher frequency than those with ‘non‑mass’ type lesions. There was a statistically significant difference between the two groups (P=0.018). In conclusion, PET/MRI is a different diagnostic approach that utilizes a multi‑modality system. It demonstrates reasonable diagnostic accuracies of the responses of NAC with reference to hormonal subtypes in breast cancer.

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