The use of molecular breast imaging to assess response in women undergoing neoadjuvant therapy for breast cancer: A pilot study

Dietlind L. Wahner-Roedler, Judy C. Boughey, Carrie B. Hruska, Beiyun Chen, Deborah J. Rhodes, Cindy L. Tortorelli, Robert W. Maxwell, Stephen S. Cha, Michael K. Oconnor

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Purpose of the Report: To report our findings from a prospective pilot study evaluating the accuracy of molecular breast imaging (MBI) in assessing tumor response to neoadjuvant therapy (NT) for breast cancer. MATERIALS AND Methods: Twenty patients with newly diagnosed invasive breast cancer who were scheduled to receive NT underwent MBI before beginning and after completing NT before surgery. MBI was performed using a dual-detector cadmium-zinc-telluride gamma camera system mounted on a modified mammography gantry after patients had received an intravenous injection of 20 mCi of Tc sestamibi. Tumor extent was measured on MBI, and tumor-to-background (T/B) ratios of radiotracer uptake were determined through region-of-interest analysis. Pathologic measurement of tumor size was used as a standard and compared with post-NT tumor size derived from MBI. Results: Three patients in whom post-NT MBI could not be performed because of scheduling problems were excluded from analysis. Eighteen cancers were diagnosed in 17 patients. A correlation coefficient of r = 0.681 (P = 0.002) was found between MBI and residual tumor size. The average T/B ratio on MBI decreased from a pretreatment value of 3.0 to a posttreatment value of 1.4. The relative decrease in T/B ratio did not appear to be predictive of response. Conclusions: Measurements of tumor size by MBI and T/B ratios are limited in their predictive value regarding the pathologic extent of residual disease in women treated with NT for breast cancer. Alternate tumor-specific radiopharmaceuticals should be evaluated to provide information to improve planning and monitoring of breast cancer treatment.

Original languageEnglish (US)
Pages (from-to)344-350
Number of pages7
JournalClinical nuclear medicine
Volume37
Issue number4
DOIs
StatePublished - Apr 1 2012

Keywords

  • molecular breast imaging
  • neoadjuvant chemotherapy
  • neoadjuvant therapy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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