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Original research
Weibing Miao
First Affiliated Hospital of Fujian Medical University
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background and Purpose
Technetium 99m-dimeric cyclic RGD peptides with three polyethylene glycol spacers (99mTc-3PRGD2) had a good performance for diagnosing breast cancer. The prospective study was to assess the performance of 99mTc-3PRGD2 tumor imaging for predicting pathological complete response (pCR) outcomes to neoadjuvant chemotherapy (NAC) in breast cancer patients.
Materials and Methods
Forty-one patients were examined using both 99mTc-3PRGD2 and 18F-fluoro-deoxy-glucose (18F-FDG) imaging before NAC (baseline), and after the first and fifth NAC cycle. The tumor-to-background (T/B) ratios for 99mTc-3PRGD2 imaging and the maximum standardized uptake values (SUVmax) from the 18F-FDG imaging in breast tumors and axillary lymph node (ALN) metastases were separately calculated and analyzed—based on receiver operating characteristic (ROC) analysis.
Results
Finally, pCR was achieved in 13 of 41 patients after NAC. The area under curve (AUC) of T/B changes (ΔT/B) in breast tumors for predicting pCR after first and fifth cycle were 0.827 and 0.687, and 0.859 and 0.778 in ALN metastases, respectively. For SUVmax changes (ΔSUVmax), the ROC-AUC were 0.859 and 0.713, as well as 0.572 and 0.802, respectively. In breast tumors, the AUCs of ΔT/B1 and ΔSUVmax1 had no significant difference (P > 0.05). However, the AUC of ΔT/B1 was significantly higher than for ΔSUVmax1 in ALN metastases (Z = 2.10, P = 0.035). Additionally, the T/B1 trends for breast tumor and ALN in pCR group were higher than for non-pCR group in HER2-positive patients (P﹤0.05).
Conclusions
Compared with 18F-FDG imaging, our study shows that use of 99mTc-3PRGD2 imaging offered a similar level of predictive performance for breast cancer pCR to NAC, and early T/B1 trends of ALN showed an higher performance for predicting pCR.
Trial Registration
ClinicalTrials.gov ID: NCT02742168.
Keywords
breast cancer, pathological complete response, 99mTc-3PRGD2, 18F-FDG, neoadjuvant chemotherapy
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This is a preprint. It has not completed peer review.
Original research
Weibing Miao
First Affiliated Hospital of Fujian Medical University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 22 Sep, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Nuclear Medicine & Medical Imaging
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background and Purpose
Technetium 99m-dimeric cyclic RGD peptides with three polyethylene glycol spacers (99mTc-3PRGD2) had a good performance for diagnosing breast cancer. The prospective study was to assess the performance of 99mTc-3PRGD2 tumor imaging for predicting pathological complete response (pCR) outcomes to neoadjuvant chemotherapy (NAC) in breast cancer patients.
Materials and Methods
Forty-one patients were examined using both 99mTc-3PRGD2 and 18F-fluoro-deoxy-glucose (18F-FDG) imaging before NAC (baseline), and after the first and fifth NAC cycle. The tumor-to-background (T/B) ratios for 99mTc-3PRGD2 imaging and the maximum standardized uptake values (SUVmax) from the 18F-FDG imaging in breast tumors and axillary lymph node (ALN) metastases were separately calculated and analyzed—based on receiver operating characteristic (ROC) analysis.
Results
Finally, pCR was achieved in 13 of 41 patients after NAC. The area under curve (AUC) of T/B changes (ΔT/B) in breast tumors for predicting pCR after first and fifth cycle were 0.827 and 0.687, and 0.859 and 0.778 in ALN metastases, respectively. For SUVmax changes (ΔSUVmax), the ROC-AUC were 0.859 and 0.713, as well as 0.572 and 0.802, respectively. In breast tumors, the AUCs of ΔT/B1 and ΔSUVmax1 had no significant difference (P > 0.05). However, the AUC of ΔT/B1 was significantly higher than for ΔSUVmax1 in ALN metastases (Z = 2.10, P = 0.035). Additionally, the T/B1 trends for breast tumor and ALN in pCR group were higher than for non-pCR group in HER2-positive patients (P﹤0.05).
Conclusions
Compared with 18F-FDG imaging, our study shows that use of 99mTc-3PRGD2 imaging offered a similar level of predictive performance for breast cancer pCR to NAC, and early T/B1 trends of ALN showed an higher performance for predicting pCR.
Trial Registration
ClinicalTrials.gov ID: NCT02742168.
Figure 1
Figure 2
Figure 3
Figure 4
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