Background/objectives: Pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) in breast cancer (BC) is a solid indicator of favourable prognosis, potentially also being useful for more conservative patient management. We aim to explore the potential of [18F]FDG PET/CT as a non-invasive method to predict response to NAC.Methods: In this prospective, observational cohort study, we enrolled BC patient candidates for NAC who underwent baseline and preoperative [18F]FDG PET/CT. NAC response was determined using final histopathology. PET images were assessed qualitatively and semi-quantitatively, and the findings correlated with NAC response.Results: In total, 133 BC patients were included. The visual analysis of preoperative PET/CT detected residual disease (RD) with high specificity (>93%) and moderate sensitivity, based on pCR/RD classification and RCB index. Semiquantitative measures (SUVmax, TBR) were significantly higher in non-responders across the classification methods (p< 0.001 for all).Conclusions: These findings highlight the potential of preoperative [18F]FDG PET/CT as a complementary tool for identifying excellent responders to NAC across BC subtypes or response criteria. This could inform personalised treatment and potentially allow for surgery to be omitted in selected patients.
**背景/目的：** 乳腺癌新辅助化疗后的病理完全缓解是良好预后的可靠指标，也可能有助于更保守的患者管理。本研究旨在探讨[18F]FDG PET/CT作为一种无创性方法预测新辅助化疗疗效的潜力。 **方法：** 在这项前瞻性观察性队列研究中，我们纳入了计划接受新辅助化疗的乳腺癌患者，这些患者在基线期和术前均接受了[18F]FDG PET/CT检查。新辅助化疗的疗效通过最终的组织病理学结果判定。对PET图像进行定性和半定量评估，并将结果与新辅助化疗疗效相关联。 **结果：** 研究共纳入133例乳腺癌患者。基于病理完全缓解/残留病灶分类及残留癌症负荷指数，术前PET/CT的视觉分析检测残留病灶具有高特异性（>93%）和中等的敏感性。在所有分类方法中，无应答者的半定量指标（最大标准化摄取值、肿瘤背景比）均显著更高（所有p值均<0.001）。 **结论：** 这些发现凸显了术前[18F]FDG PET/CT作为一种辅助工具，在识别不同乳腺癌亚型或不同疗效标准下对新辅助化疗极佳应答者方面的潜力。这可能为个体化治疗提供信息，并有望使部分选定患者免于手术。
肿瘤(癌症)患者之家