The Use of Molecular Breast Imaging to Assess Response in Women Undergoing Neoadjuvant Therapy for Breast Cancer: a Pilot Study

Overview

Journal Clin Nucl Med

Specialty Nuclear Medicine

Date 2012 Mar 7

PMID 22391702

Citations 6

Authors

Dietlind L Wahner-Roedler

Judy C Boughey

Carrie B Hruska

Beiyun Chen

Deborah J Rhodes

Cindy L Tortorelli

Robert W Maxwell

Stephen S Cha

Michael K OConnor

Affiliations

Soon will be listed here.

Abstract

Purpose Of The Report: To report our findings from a prospective pilot study evaluating the accuracy of molecular breast imaging (MBI) in assessing tumor response to neoadjuvant therapy (NT) for breast cancer.

Materials And Methods: Twenty patients with newly diagnosed invasive breast cancer who were scheduled to receive NT underwent MBI before beginning and after completing NT before surgery. MBI was performed using a dual-detector cadmium-zinc-telluride gamma camera system mounted on a modified mammography gantry after patients had received an intravenous injection of 20 mCi of 99mTc sestamibi. Tumor extent was measured on MBI, and tumor-to-background (T/B) ratios of radiotracer uptake were determined through region-of-interest analysis. Pathologic measurement of tumor size was used as a standard and compared with post-NT tumor size derived from MBI.

Results: Three patients in whom post-NT MBI could not be performed because of scheduling problems were excluded from analysis. Eighteen cancers were diagnosed in 17 patients. A correlation coefficient of r = 0.681 (P = 0.002) was found between MBI and residual tumor size. The average T/B ratio on MBI decreased from a pretreatment value of 3.0 to a posttreatment value of 1.4. The relative decrease in T/B ratio did not appear to be predictive of response.

Conclusions: Measurements of tumor size by MBI and T/B ratios are limited in their predictive value regarding the pathologic extent of residual disease in women treated with NT for breast cancer. Alternate tumor-specific radiopharmaceuticals should be evaluated to provide information to improve planning and monitoring of breast cancer treatment.

Citing Articles

Dedicated Breast Gamma Camera Imaging and Breast PET: Current Status and Future Directions.

Narayanan D, Berg W PET Clin. 2018; 13(3):363-381.

PMID: 30100076 PMC: 6116731. DOI: 10.1016/j.cpet.2018.02.008.

The role of molecular breast imaging in predicting complete tumor response to treatment and residual tumor extent following neoadjuvant therapy.

Nuvoli S, Galassi S, Gelo I, Rocchitta G, Fancellu A, Serra P Oncol Rep. 2018; 39(5):2055-2062.

PMID: 29512735 PMC: 5928762. DOI: 10.3892/or.2018.6299.

Direct-Conversion Molecular Breast Imaging of Invasive Breast Cancer: Imaging Features, Extent of Invasive Disease, and Comparison Between Invasive Ductal and Lobular Histology.

Conners A, Jones K, Hruska C, Geske J, Boughey J, Rhodes D AJR Am J Roentgenol. 2015; 205(3):W374-81.

PMID: 26295674 PMC: 8900216. DOI: 10.2214/AJR.14.13502.

⁹⁹mTc-3PRGD₂ SPECT to monitor early response to neoadjuvant chemotherapy in stage II and III breast cancer.

Ji B, Chen B, Wang T, Song Y, Chen M, Ji T Eur J Nucl Med Mol Imaging. 2015; 42(9):1362-70.

PMID: 25947573 DOI: 10.1007/s00259-015-3062-1.

Nuclear imaging of the breast: translating achievements in instrumentation into clinical use.

Hruska C, OConnor M Med Phys. 2013; 40(5):050901.

PMID: 23635248 PMC: 3656956. DOI: 10.1118/1.4802733.

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