Baseline ¹⁸F-FDG PET/CT for predicting pathological response to neoadjuvant chemotherapy and prognosis in locally advanced breast cancer patients: analysis of tumor and lymphoid organs metabolic parameters.

IF 9.7 1区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Radiologia Medica Pub Date : 2025-02-12 DOI:10.1007/s11547-025-01961-9

Silvia Taralli, Armando Orlandi, Pia Clara Pafundi, Valeria Tempesta, Alba Di Leone, Letizia Pontolillo, Lorenzo Scardina, Margherita Lorusso, Ida Paris, Maria Lucia Calcagni

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引用次数: 0

Abstract

Purpose: To investigate metabolic parameters from baseline ¹⁸F-FDG PET/CT as predictors of pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) and disease recurrence in locally advanced breast cancer (LABC) patients.

Materials and methods: From 142 LABC in 137 patients (bilateral-synchronous BC: 5/137), the following parameters from baseline (pre-treatment) ¹⁸F-FDG PET/CT were retrospectively analyzed, along with clinic-histological data: primary tumor activity (SUVmax, SUVmean, SUVpeak, tumor-to-liver ratio-TLR-, MTV, TLG); lymphoid organs activity (spleen and bone marrow SUVmax and SUVmean, spleen-to-liver ratio-SLR-, bone marrow-to-liver ratio-BLR); and PET-positive lymph-nodes' number. Predictors of pCR and recurrence-free survival (RFS) were assessed by univariable logistic regression and Cox regression (significant or suggestive association: p < 0.05; p < 0.10).

Results: 74/142 tumors were "Luminal A/B HER2-", 44/142 "Luminal B HER2+/HER2+", 24/142 TNBC; pCR after NAC occurred in 26/142 tumors (18.3%) and disease recurrence at follow-up (45 ± 18.1 months) in 25/127 assessable patients (19.7%). Significant or suggestive predictors of NAC response, in Luminal A/B HER2-: lower spleen SUVmax and patients' age (OR 0.06; 0.93) for pCR; lower TLRmax, TLRmean and BLRmax (OR 1.33; 1.22; and 26.42) for residual disease. Significant negative RFS predictors: higher SUVmax, SUVmean, SUVpeak (HR 1.10; 1.15; 1.11), TLRmax and TLRmean (HR 1.02; 1.00), MTV and TLG (HR 1.32; 1.26) in Luminal A/B HER2-; higher spleen SUVmax, PET-positive nodes' number and patients' age (HR 6.24; 1.20; 1.08) in Luminal B HER2+/HER2+.

Conclusion: Primary tumor and lymphoid organs parameters at baseline ¹⁸F-FDG PET/CT resulted as predictors of NAC response and prognosis in LABC patients, respectively, reflecting the BC cells' proliferative activity and metabolic burden, and the role of tumor-induced immune-system activation on tumors' behavior and treatment responsiveness. In LABC candidates to NAC, baseline PET information could improve treatment planning and prognostic stratification.

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来源期刊

Radiologia Medica 医学-核医学

CiteScore

14.10

自引率

7.90%

发文量

133

审稿时长

4-8 weeks

期刊介绍： Felice Perussia founded La radiologia medica in 1914. It is a peer-reviewed journal and serves as the official journal of the Italian Society of Medical and Interventional Radiology (SIRM). The primary purpose of the journal is to disseminate information related to Radiology, especially advancements in diagnostic imaging and related disciplines. La radiologia medica welcomes original research on both fundamental and clinical aspects of modern radiology, with a particular focus on diagnostic and interventional imaging techniques. It also covers topics such as radiotherapy, nuclear medicine, radiobiology, health physics, and artificial intelligence in the context of clinical implications. The journal includes various types of contributions such as original articles, review articles, editorials, short reports, and letters to the editor. With an esteemed Editorial Board and a selection of insightful reports, the journal is an indispensable resource for radiologists and professionals in related fields. Ultimately, La radiologia medica aims to serve as a platform for international collaboration and knowledge sharing within the radiological community.