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Advances in PET/CT Imaging for Breast Cancer Patients and Beyond
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Advances in PET/CT Imaging for Breast Cancer Patients and Beyond

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nuclear Medicine & Radiology".

Deadline for manuscript submissions: closed (25 May 2023) | Viewed by 9766

Special Issue Editors

Dr. Romain David Seban

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Guest Editor
1. Department of Nuclear Medicine and Endocrine Oncology, Institut Curie, 92210 Saint-Cloud, France
2. Laboratoire d'Imagerie Translationnelle en Oncologie, Inserm, Institut Curie, 91401 Orsay, France
Interests: PET/CT imaging; new tracers; breast cancer; prognostic/predictive biomarkers; precision medicine
Special Issues, Collections and Topics in MDPI journals
Dr. Laurent Dercle

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Guest Editor
Department of Radiology, Columbia University Medical Center and New York Presbyterian Hospital, New York, NY, USA
Interests: artificial intelligence; radiomics; immunotherapy
Special Issues, Collections and Topics in MDPI journals
Dr. Antoine Girard

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Guest Editor
1. Department of Nuclear Medicine, Centre Eugène Marquis, Université Rennes 1, 35000 Rennes, France
2. LTSI (Laboratoire Traitement du Signal et de l'Image), Université de Rennes 1, 35042 Rennes, France
Interests: medical imaging; nuclear medicine; lobular breast cancer; brain metastases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Over the last decade, molecular imaging has remarkably improved the management of patients with breast cancer. 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is now a cornerstone for in vivo characterization and measurement of biologic processes, with several clinical applications, such as staging and assessment of treatment response. Moreover, innovative PET radiotracers present novel clinical opportunities, such as the selection of patients for endocrine therapy, anti-HER2 therapy, and immunotherapy. For patients with metastatic breast cancer, 18F-fluoroestradiol (FES) is a promising tracer that can be used for a whole-body assessment of estrogen receptor status. The fibroblast activation protein inhibitor (FAPI), labeled with Gallium-68 or Fluor-18, is also under investigation, with encouraging results. Thus,  several research teams have recently studied  FAPIs’ potential to compete with or even outperform FDG in a number of clinical indications, including diagnosis/staging, treatment response assessment, radiotherapy planning, and theranostics. For this Special Issue, we encourage the submission of papers considering innovative approaches using PET/CT imaging to guide the management of patients with a diagnosis of breast cancer.

Dr. Romain David Seban
Dr. Laurent Dercle
Dr. Antoine Girard
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • breast cancer
  • PET/CT imaging
  • fluorodeoxyglucose (FDG)
  • fluoroestradiol (FES)
  • tracers targeting fibroblast activation protein inhibitors (FAPI)

Related Special Issue

Published Papers (5 papers)

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Editorial

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6 pages, 229 KiB  
Editorial
Advances in PET/CT Imaging for Breast Cancer Patients and Beyond
by David Khalil, Andrew Lotfalla, Antoine Girard, Richard Ha, Laurent Dercle and Romain-David Seban
J. Clin. Med. 2023, 12(2), 651; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12020651 - 13 Jan 2023
Cited by 1 | Viewed by 1333
Abstract
Breast cancer is the most common cancer in women around the world and the fifth leading cause of cancer-related death [...] Full article
(This article belongs to the Special Issue Advances in PET/CT Imaging for Breast Cancer Patients and Beyond)

Research

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13 pages, 1484 KiB  
Article
Clinical Utility of Pre-Therapeutic [18F]FDG PET/CT Imaging for Predicting Outcomes in Breast Cancer
by Sophia Najid, Romain-David Seban, Laurence Champion, Alexandre De Moura, Clara Sebbag, Hélène Salaün, Luc Cabel and Claire Bonneau
J. Clin. Med. 2023, 12(17), 5487; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12175487 - 24 Aug 2023
Viewed by 871
Abstract
Background: [18F]FDG PET/CT is used for staging and could also provide information associated with clinical outcomes. The objective of this study was to determine the clinical utility of biomarkers measured using [18F]FDG PET/CT to predict the absence of pathological complete response (no-pCR) and [...] Read more.
Background: [18F]FDG PET/CT is used for staging and could also provide information associated with clinical outcomes. The objective of this study was to determine the clinical utility of biomarkers measured using [18F]FDG PET/CT to predict the absence of pathological complete response (no-pCR) and recurrence. Methods: In this retrospective study, we included patients with non-special-type breast carcinoma who underwent [18F]FDG PET/CT before neoadjuvant chemotherapy between 2011 and 2019. Clinicopathological data were collected. Tumor SUVmax and total metabolic tumor volume (TMTV) were measured from PET images. The association between biomarkers and no-pCR was studied using logistic regression. The cut-off value was determined using the area under the ROC Curve. To predict 3-year recurrence-free survival (RFS), we used a multivariable Cox model, and the cut-off value was determined using time-dependent ROC and predictiveness curves. Results: Two hundred and eighty-six patients were included in the analysis. One hundred and twelve patients had a pCR (39.2%). The pCR rate was significantly higher in patients with a high nuclear grade (p < 0.01), HER2+ and TNBC subtypes (p < 0.01), high Ki67 (p < 0.01), and low TMTV (p < 0.01). A high TMTV value (>9.0 cm3) was significantly associated with no-pCR in the whole cohort (OR = 2.4, 95% CI: 1.3–4.2, p < 0.01). After a median follow-up of 4.5 years, 65 patients experienced recurrence and 39 patients died. High TMTV (>13.5 cm3) was associated with shorter RFS (HR = 4.0, 95% CI: 1.9–8.4, p < 0.01). Conclusion: High TMTV in pre-therapeutic imaging is associated with no-pCR and recurrence. It can help in identifying high-risk patients and be considered as an intensified or alternative adjuvant therapy for closely monitoring patients. Full article
(This article belongs to the Special Issue Advances in PET/CT Imaging for Breast Cancer Patients and Beyond)
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15 pages, 2090 KiB  
Article
Performance of [18F]FDG-PET/CT Imaging in First Recurrence of Invasive Lobular Carcinoma
by David Bonnin, Sylvain Ladoire, Nathalie Briot, Aurélie Bertaut, Clément Drouet, Alexandre Cochet and Jean-Louis Alberini
J. Clin. Med. 2023, 12(8), 2916; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12082916 - 17 Apr 2023
Cited by 1 | Viewed by 1560
Abstract
Background: Invasive lobular carcinoma accounts for 10 to 15% of all breast cancers. The first objective of this retrospective study was to assess the diagnostic performance of FDG-PET/CT scanning in women previously treated for invasive lobular carcinoma with suspected first recurrence. The secondary [...] Read more.
Background: Invasive lobular carcinoma accounts for 10 to 15% of all breast cancers. The first objective of this retrospective study was to assess the diagnostic performance of FDG-PET/CT scanning in women previously treated for invasive lobular carcinoma with suspected first recurrence. The secondary objectives were to evaluate the impact of PET/CT in a change in treatment and its prognostic value on specific survival. Methods: Patients in whom a PET/CT scan was performed from January 2011 to July 2019 in our Cancer Research Center were enrolled. Recurrence was suspected based on clinical symptoms, abnormal findings on conventional imaging, and/or elevated tumor markers. The diagnosis of recurrence was established by the oncologist after integration of all clinical, biological, histological, imaging, and follow-up data. Prognostic factors of recurrence as predicted by PET were determined using univariate logistic regression. KI67, mitotic index, or grade of mitosis were tested. Survival curves were compared using the log-rank test. Sixty-four patients (mean age: 60.3; SD = 12.4 years) were enrolled. The average time from initial diagnosis of the primary tumor to suspicion of recurrence was 5.2 ± 4.1 years. Forty-eight patients (75%) were judged to have recurrence by the oncologist: 7 local and 41 metastatic, with mainly bone (n = 24), lymph node (n = 14) and liver (n = 10) metastases. Results: Sensitivity, specificity, and positive and negative predictive values of PET/CT to predict recurrence were, respectively: 87%, 87%, 95%, and 70%. SUVmax at recurrence sites was generally high (mean: 6.4; SD = 2.9). False negative PET/CT results occurred with local (n = 2), peritoneal (n = 2), meningeal (n = 1), or bladder (n = 1) recurrences. In 40 patients with available histopathological data from suspected sites of recurrence, 30 PET/CT were true positive. In four patients, primary lung (n = 1) or gastric (n = 1) tumors or lymphomas (n = 2) were found. The detection of a recurrence resulted in a change in treatment in 44/48 patients (92%). No association between recurrence predicted by PET and biological biomarkers was found. Median specific survival appears shorter in patients with metastatic recurrence versus patients with local or no recurrence on PET/CT (p = 0.067). Conclusions: FDG-PET/CT is an effective and reliable tool for the detection of invasive lobular carcinoma recurrence, although certain recurrence sites specific to this histological type can impair its diagnostic performance. Full article
(This article belongs to the Special Issue Advances in PET/CT Imaging for Breast Cancer Patients and Beyond)
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Review

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16 pages, 4120 KiB  
Review
Comparison of MRI vs. [18F]FDG PET/CT for Treatment Response Evaluation of Primary Breast Cancer after Neoadjuvant Chemotherapy: Literature Review and Future Perspectives
by Matteo Caracciolo, Angelo Castello, Luca Urso, Francesca Borgia, Maria Cristina Marzola, Licia Uccelli, Corrado Cittanti, Mirco Bartolomei, Massimo Castellani and Egesta Lopci
J. Clin. Med. 2023, 12(16), 5355; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12165355 - 17 Aug 2023
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Abstract
The purpose of this systematic review was to investigate the diagnostic accuracy of [18F]FDG PET/CT and breast MRI for primary breast cancer (BC) response assessment after neoadjuvant chemotherapy (NAC) and to evaluate future perspectives in this setting. We performed a critical [...] Read more.
The purpose of this systematic review was to investigate the diagnostic accuracy of [18F]FDG PET/CT and breast MRI for primary breast cancer (BC) response assessment after neoadjuvant chemotherapy (NAC) and to evaluate future perspectives in this setting. We performed a critical review using three bibliographic databases (i.e., PubMed, Scopus, and Web of Science) for articles published up to the 6 June 2023, starting from 2012. The Quality Assessment of Diagnosis Accuracy Study (QUADAS-2) tool was adopted to evaluate the risk of bias. A total of 76 studies were identified and screened, while 14 articles were included in our systematic review after a full-text assessment. The total number of patients included was 842. Eight out of fourteen studies (57.1%) were prospective, while all except one study were conducted in a single center. In the majority of the included studies (71.4%), 3.0 Tesla (T) MRI scans were adopted. Three out of fourteen studies (21.4%) used both 1.5 and 3.0 T MRI and only two used 1.5 T. [18F]FDG was the radiotracer used in every study included. All patients accepted surgical treatment after NAC and each study used pathological complete response (pCR) as the reference standard. Some of the studies have demonstrated the superiority of [18F]FDG PET/CT, while others proved that MRI was superior to PET/CT. Recent studies indicate that PET/CT has a better specificity, while MRI has a superior sensitivity for assessing pCR in BC patients after NAC. The complementary value of the combined use of these modalities represents probably the most important tool to improve diagnostic performance in this setting. Overall, larger prospective studies, possibly randomized, are needed, hopefully evaluating PET/MR and allowing for new tools, such as radiomic parameters, to find a proper place in the setting of BC patients undergoing NAC. Full article
(This article belongs to the Special Issue Advances in PET/CT Imaging for Breast Cancer Patients and Beyond)
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17 pages, 3101 KiB  
Review
State of the Art in 2022 PET/CT in Breast Cancer: A Review
by Jules Zhang-Yin
J. Clin. Med. 2023, 12(3), 968; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12030968 - 27 Jan 2023
Cited by 1 | Viewed by 3766
Abstract
Molecular imaging with positron emission tomography is a powerful and well-established tool in breast cancer management. In this review, we aim to address the current place of the main PET radiopharmaceuticals in breast cancer care and offer perspectives on potential future radiopharmaceutical and [...] Read more.
Molecular imaging with positron emission tomography is a powerful and well-established tool in breast cancer management. In this review, we aim to address the current place of the main PET radiopharmaceuticals in breast cancer care and offer perspectives on potential future radiopharmaceutical and technological advancements. A special focus is given to the following: the role of 18F-fluorodeoxyglucose positron emission tomography in the clinical management of breast cancer patients, especially during staging; detection of recurrence and evaluation of treatment response; the role of 16α-18Ffluoro-17β-oestradiol positron emission tomography in oestrogen receptors positive breast cancer; the promising radiopharmaceuticals, such as 89Zr-trastuzumab and 68Ga- or 18F-labeled fibroblast activation protein inhibitor; and the application of artificial intelligence. Full article
(This article belongs to the Special Issue Advances in PET/CT Imaging for Breast Cancer Patients and Beyond)
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