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Background <p>This study aimed to investigate the prognostic value of molecular and radiologic characteristics of the primary tumour and axillary lymph nodes (ALNs) on dedicated breast [<sup>18</sup>F]FDG PET/MRI in terms of event-free survival (EFS; recurrence and/or death) in breast cancer patients treated with neoadjuvant chemotherapy (NAC). Patients diagnosed with cT2-4N0 or cT1-4N + breast cancer underwent dedicated breast [<sup>18</sup>F]FDG PET/MRI pre-, mid-, and post-NAC for response assessment between 2015–2017. Follow-up data per patient on recurrence and death were collected up to July 2025. To evaluate the prognostic value of variables for EFS, time-to-event analyses were used. P-values &lt; 0.10 were considered to indicate statistical significance.</p> Results <p>41 patients with 42 breast tumours underwent dedicated breast [<sup>18</sup>F]FDG PET/MRI pre-, mid- and post-NAC for response assessment. Median follow-up time was almost nine years. Univariate Cox regression showed no significant association between pre- and mid-NAC PET- and MRI-derived parameters and EFS. Post-NAC, a higher maximum standardized uptake value (SUVmax; HR 1.41 [90% CI 1.04–1.92], p = 0.029), SUVpeak (HR 1.79 [90% CI 1.04–3.09], p = 0.035), SUVmean (HR 1.80 [90% CI 1.01–3.22], p = 0.046), tumour size (HR 1.04 [90% CI 0.99–1.09], p = 0.087) and signal enhancement ratio (SER; HR 6.46 [90% CI 0.79–52.55], p = 0.081) of the primary tumour were significantly (p &lt; 0.10) associated with recurrence and/or death.</p> Conclusions <p>For PET- and MRI-derived parameters, several post-NAC values were predictive of EFS, but no significant association between pre- and mid-NAC values and EFS was found.</p>

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Prognostic value of molecular and radiologic characteristics on dedicated breast [18F]FDG PET/MRI in breast cancer patients treated with neoadjuvant chemo(targeted) therapy: a retrospective cohort study

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  • 发表日期：

    2025年12月5日

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  • Melissa Lenaerts,
  • Cornelis M. de Mooij,
  • Janneke B. Houwers,
  • Cristina Mitea,
  • Marco Panosetti,
  • Maaike de Boer,
  • Kristien B. M. I. Keymeulen,
  • Felix M. Mottaghy,
  • Marc B. I. Lobbes,
  • Patty J. Nelemans,
  • Marjolein L. Smidt,
  • Thiemo J. A. van Nijnatten

摘要

Background

This study aimed to investigate the prognostic value of molecular and radiologic characteristics of the primary tumour and axillary lymph nodes (ALNs) on dedicated breast [18F]FDG PET/MRI in terms of event-free survival (EFS; recurrence and/or death) in breast cancer patients treated with neoadjuvant chemotherapy (NAC). Patients diagnosed with cT2-4N0 or cT1-4N + breast cancer underwent dedicated breast [18F]FDG PET/MRI pre-, mid-, and post-NAC for response assessment between 2015–2017. Follow-up data per patient on recurrence and death were collected up to July 2025. To evaluate the prognostic value of variables for EFS, time-to-event analyses were used. P-values < 0.10 were considered to indicate statistical significance.

Results

41 patients with 42 breast tumours underwent dedicated breast [18F]FDG PET/MRI pre-, mid- and post-NAC for response assessment. Median follow-up time was almost nine years. Univariate Cox regression showed no significant association between pre- and mid-NAC PET- and MRI-derived parameters and EFS. Post-NAC, a higher maximum standardized uptake value (SUVmax; HR 1.41 [90% CI 1.04–1.92], p = 0.029), SUVpeak (HR 1.79 [90% CI 1.04–3.09], p = 0.035), SUVmean (HR 1.80 [90% CI 1.01–3.22], p = 0.046), tumour size (HR 1.04 [90% CI 0.99–1.09], p = 0.087) and signal enhancement ratio (SER; HR 6.46 [90% CI 0.79–52.55], p = 0.081) of the primary tumour were significantly (p < 0.10) associated with recurrence and/or death.

Conclusions

For PET- and MRI-derived parameters, several post-NAC values were predictive of EFS, but no significant association between pre- and mid-NAC values and EFS was found.