Multimodal serial assessment of neoadjuvant therapy response and recurrence-free survival in locally advanced breast cancer

We investigated the combination of DCE-MRI and 18F-FDG PET for assessing metabolism/perfusion mismatch and predicting pathological response and recurrence-free survival (RFS) in women undergoing neoadjuvant chemotherapy (NAC) for breast cancer. Thirty-five patients with localized breast cancer were imaged with both modalities at 3 timepoints over the course of NAC. Greater mid-treatment decreases in imaging measures were predictive of pathological response and associated with improved long-term outcome. Furthermore, mid-treatment decreases in metabolism/perfusion ratios were predictive of RFS. These results indicate a complementary relationship between DCE-MRI and 18F-FDG PET metrics and potential value of metabolism/perfusion mismatch as a marker of response.