FDG-PET/CT for response monitoring in metastatic breast cancer: The feasibility and benefits of applying PERCIST

Marianne Vogsen, Jakob Lykke Bülow, Lasse Ljungstrøm, Hjalte Rasmus Oltmann, Tural Asgharzadeh Alamdari, Mohammad Naghavi-Behzad, Poul-Erik Braad, Oke Gerke, Malene Grubbe Hildebrandt

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Abstract

BACKGROUND: We aimed to examine the feasibility and potential benefit of applying PET Response Criteria in Solid Tumors (PERCIST) for response monitoring in metastatic breast cancer (MBC). Further, we introduced the nadir scan as a reference.

METHODS: Response monitoring FDG-PET/CT scans in 37 women with MBC were retrospectively screened for PERCIST standardization and measurability criteria. One-lesion PERCIST based on changes in SULpeak measurements of the hottest metastatic lesion was used for response categorization. The baseline (PERCIST baseline) and the nadir scan (PERCIST nadir) were used as references for PERCIST analyses.

RESULTS: Metastatic lesions were measurable according to PERCIST in 35 of 37 (94.7%) patients. PERCIST was applied in 150 follow-up scans, with progression more frequently reported by PERCIST nadir (36%) than PERCIST baseline (29.3%; p = 0.020). Reasons for progression were (a) more than 30% increase in SUL peak of the hottest lesion ( n = 7, 15.9%), (b) detection of new metastatic lesions ( n = 28, 63.6%), or both (a) and (b) ( n = 9, 20.5%).

CONCLUSIONS: PERCIST, with the introduction of PERCIST nadir, allows a graphical interpretation of disease fluctuation that may be beneficial in clinical decision-making regarding potential earlier termination of non-effective toxic treatment. PERCIST seems feasible for response monitoring in MBC but prospective studies are needed to come this closer.

Original languageEnglish
Article number723
JournalDiagnostics
Volume11
Issue number4
Number of pages13
ISSN2075-4418
DOIs
Publication statusPublished - 19. Apr 2021

Bibliographical note

Funding Information:
Funding: This research was funded by Mrs. Astrid Thaysens grant, Qvesehls grant, The Independent Research Fund Denmark (DFF—7016-00359), the University of Southern Denmark (Ph.D. grant), Odense University Hospital (Ph.D. grant), and the Centre for Personalized Response Monitoring in Oncology (PREMIO), Odense University Hospital, Odense, Denmark.

Funding Information:
This research was funded by Mrs. Astrid Thaysens grant, Qvesehls grant, The Independent Research Fund Denmark (DFF?7016-00359), the University of Southern Denmark (Ph.D. grant), Odense University Hospital (Ph.D. grant), and the Centre for Personalized Response Monitoring in Oncology (PREMIO), Odense University Hospital, Odense, Denmark.

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Keywords

  • Metastatic breast cancer
  • PERCIST
  • Response monitoring
  • SULpeak
  • Visual assessment

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