Quantitative evaluation of Therapeutic response by FDG-PET–CT in Metastatic Breast Cancer
Résumé
Purpose: To assess the therapeutic response for metastatic breast cancer with 18 F-FDG position emission tomography (PET), this retrospective study aims to compare the performance of six different metabolic metrics with PERCIST, PERCIST with optimal thresholds, and an image-based parametric approach. Methods: Thirty-six metastatic breast cancer patients underwent 128 PET scans and 123 lesions were identified. In a per-lesion and per-patient analysis, the performance of six metrics: maximum standardized uptake value (SUVmax), SUVpeak, standardized added metabolic activity (SAM), SUVmean, metabolic volume (MV), total lesion glycolysis (TLG), and a parametric approach (SULTAN) were determined and compared to the gold standard (defined by clinical assessment and biological and conventional imaging according RECIST 1.1). The evaluation was performed using PERCIST thresholds (for per-patient analysis only) and optimal thresholds (determined by the Youden criterion from the receiver operating characteristic curves). results: In the per-lesion analysis, 210 pairs of lesion evolutions were studied. Using the optimal thresholds, SUVmax, SUVpeak, SUVmean, SAM, and TLG were significantly correlated with the gold standard. SUVmax, SUVpeak, and SUVmean reached the best sensitivity (91, 88, and 83%, respectively), specificity (93, 95, and 97%, respectively), and negative predictive value (NPV, 90, 88, and 83%, respectively). For the per-patient analysis, 79 pairs of PET were studied. The optimal thresholds compared to the PERCIST threshold did not improve performance for SUVmax, SUVpeak, and SUVmean. Only SUVmax, SUVpeak, SUVmean, and TLG were correlated with the gold standard. SULTAN also performed equally: 83% sensitivity, 88% specificity, and NPV 86%. conclusion: This study showed that SUVmax and SUVpeak were the best parameters for PET evaluation of metastatic breast cancer lesions. Parametric imaging is helpful in evaluating serial studies.
Mots clés
MV
metabolic volume
NPV
negative predictive value
PET
positron emission tomography
PPV
positive predictive value
ROC
receiver operating characteristic
ROI
region of interest
SAM
standardized added metabolic activity
SULTAN
longitudinal monitoring in positron factor analysis
SUL
SUV lean body mass
SUV
standard uptake value
TLG
total lesion glycolysis
TN
true negative
TP
true positive
PeT
breast cancer
PercisT
therapeutic evaluation
parametric analysis
sUlTan Abbreviations: AUC
area under curve
EORTC
European Organization for Research and Treatment of Cancer
FADS
factor analysis of dynamic sequences
FDG
fluorodeoxyglucose
FN
false negative
FP
false positive
MRI
magnetic resonance imaging
Domaines
Cancer
Origine : Fichiers produits par l'(les) auteur(s)
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