A Prospective Head-to-Head Comparison of HER2-Targeted and 18F-FDG PET/CT for Detecting Axillary Lymph Node Metastases Among Newly Diagnosed HER2-Positive and HER2-Low Breast Cancer
Prospective trial compares HER2-targeted PET/CT with 18F-FDG for nodal metastasis detection, suggesting enhanced effectiveness in HER2-positive cases.
Key Points
This study aims to evaluate the effectiveness of HER2-targeted PET/CT compared to 18F-FDG PET/CT in detecting axillary lymph node metastasis in newly diagnosed HER2-positive and HER2-low breast cancer.
Prospective study of 51 participants with HER2-positive (n=25) or HER2-low (n=26) breast cancer.
Participants underwent both 18F-FDG and Al18F-NOTA-HER2-BCH PET/CT imaging within 1 week.
Statistical analyses included paired McNemar, Wilcoxon signed-rank, and Mann-Whitney U tests.
Al18F-NOTA-HER2-BCH detected metastatic lymph nodes in 11 cases where 18F-FDG was less effective.
In HER2-positive cohorts, Al18F-NOTA-HER2-BCH showed 94% sensitivity, 94% accuracy, and 93% negative predictive value, vs. 79%, 85%, and 84% for 18F-FDG (all P<0.001).
In the HER2-low cohort, the two tracers showed similar performance, with one case of relevant nodal upstaging by 18F-FDG.