FDG-PET Metabolic Vs CT Anatomical Monitoring of Tumor Response to Anterior Chemotherapy in Breast Carcinoma-The Uncertainties

Abstract

To compare the metabolic tumor response and volumetric tumor response to pathological tumor response to NACT and to predict the sensitivity, specificity, positive predictive value and negative predictive value of FDG PET to neoadjuvant chemotherapy. Material and method: The study was performed after institutional ethical committee clearance.35 consecutive eligible patients treated between January 2015 to May 2016 were included in the study. PETCT was acquired at baseline and post neoadjuvant chemotherapy, prior to surgery. The SUV max of tumor and involved nodes at baseline and post neoadjuvant chemotherapy was compared to pathological tumor size and nodal status. Response was assessed using PRECIST and RECIST criteria. Statistical methods used for analysis were software SPSS version 13, calculations for Sensitivity, specificity, positive predictive value and negative predictive value. Results: The median age was 51.3 years (range 33 to 68 years). The patients were generally healthy with ECOG PS 0-1. FDG PET tumor to HPE correlation -sensitivity, specificity, PPV, NPV SENSITIVITY 88.8% SPECIFICITY 50% PPV 85.7% NPV 57.1% our results show the high sensitivity and low specificity of PETCT in detecting residual tumor. Overall PCR was in 22.6% (8/35). Pathological Complete Response Rates In The Axillary Node Luminal wise:Total:23/35 – 65.7%. Luminal A PCR Rate -14.4%; Luminal B PCR Rate-8.5%; TNBC PCR Rate-31.4%; HER 2-11.4%. Conclusion: