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Objective  To assess the clinical value of dual tracers Positron emission tomography/computed tomography (PET/CT)  18 F-fluoroestradiol ( 18 F-FES) and  18 F-fluorodeoxyglucose ( 18 F-FDG) in predicting neoadjuvant chemotherapy response (NAC) of breast cancer.    Methods  Eighteen consecutive patients with newly diagnosed, non-inflammatory, stage II and III breast cancer undergoing NAC were included. Before chemotherapy, they underwent both  18 F-FES and  18 F-FDG PET/CT scans. Surgery was performed after three to six cycles of chemotherapy. Tumor response was graded and divided into two groups: the responders and non-responders. We used the maximum standardized uptake value (SUVmax) to qualify each primary lesion.    Results  Pathologic analysis revealed 10 patients were responders while the other 8 patients were non-responders. There was no statistical difference of SUVmax-FDG and tumor size between these two groups ( P >0.05). On the contrary, SUVmax-FES was lower in responders (1.75±0.66 versus 4.42±1.14; U=5,  P =0.002); and SUVmax-FES/FDG also showed great value in predicting outcome (0.16±0.06 versus 0.54±0.22; U=5,  P =0.002).    Conclusions  Our study showed  18 F-FES PET/CT might be feasible to predict response of NAC. However, whether the use of dual tracers  18 F-FES and  18 F-FDG has complementary value should be further studied.

plos one

Can Positron Emission Tomography/Computed Tomography with the Dual Tracers Fluorine-18 Fluoroestradiol and Fluorodeoxyglucose Predict Neoadjuvant Chemotherapy Response of Breast Cancer? ----A Pilot Study