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Article

Quantitative Comparison of Prone and Supine PERCIST Measurements in Breast Cancer

by
Jennifer G. Whisenant
1,2,*,
Jason M. Williams
3,
Hakmook Kang
3,4,
Lori R. Arlinghaus
3,
Richard G. Abramson
1,3,5,
Vandana G. Abramson
1,2,
Kareem Fakhoury
6,
A. Bapsi Chakravarthy
1,7 and
Thomas E. Yankeelov
8
1
Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
2
Department of Medicine, Vanderbilt University Medical Center, 2220 Pierce Avenue, 691 PRB, Nashville, TN 37209, USA
3
Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
4
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
5
Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
6
Department of Radiation Oncology, University of Colorado Cancer Center—Anschutz Medical Campus, Aurora, CO, USA
7
Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
8
Oden Institute for Computational Engineering and Sciences; Livestrong Cancer Institutes; Department of Biomedical Engineering; Department of Diagnostic Medicine; and Department of Oncology, The University of Texas, Austin, TX, USA
*
Author to whom correspondence should be addressed.
Tomography 2020, 6(2), 170-176; https://doi.org/10.18383/j.tom.2020.00002
Submission received: 10 March 2020 / Revised: 13 April 2020 / Accepted: 9 May 2020 / Published: 1 June 2020

Abstract

Positron emission tomography (PET) is typically performed in the supine position. However, breast magnetic resonance imaging (MRI) is performed in prone, as this improves visibility of deep breast tissues. With the emergence of hybrid scanners that integrate molecular information from PET and functional information from MRI, it is of great interest to determine if the prognostic utility of prone PET is equivalent to supine. We compared PERCIST (PET Response Criteria in Solid Tumors) measurements between prone and supine FDG-PET in patients with breast cancer and the effect of orientation on predicting pathologic complete response (pCR). In total, 47 patients were enrolled and received up to 6 cycles of neoadjuvant therapy. Prone and supine FDG-PET were performed at baseline (t0; n = 46), after cycle 1 (t1; n = 1) or 2 (t2; n = 10), or after all neoadjuvant therapy (t3; n = 19). FDG uptake was quantified by maximum and peak standardized uptake value (SUV) with and without normalization to lean body mass; that is, SUVmax, SUVpeak, SULmax, and SULpeak. PERCIST measurements were performed for each paired baseline and post-treatment scan. Receiver operating characteristic analysis for the prediction of pCR was performed using logistic regression that included age and tumor size as covariates. SUV and SUL metrics were significantly different between orientation (P < .001), but were highly correlated (P > .98). Importantly, no differences were observed with the PERCIST measurements (P > .6). Overlapping 95% confidence intervals for the receiver operating characteristic analysis suggested no difference at predicting pCR. Therefore, prone and supine PERCIST in this data set were not statistically different.
Keywords: FDG-PET; pathological complete response; quantitative PET; 18F-fluorodeoxyglucose FDG-PET; pathological complete response; quantitative PET; 18F-fluorodeoxyglucose

Share and Cite

MDPI and ACS Style

Whisenant, J.G.; Williams, J.M.; Kang, H.; Arlinghaus, L.R.; Abramson, R.G.; Abramson, V.G.; Fakhoury, K.; Chakravarthy, A.B.; Yankeelov, T.E. Quantitative Comparison of Prone and Supine PERCIST Measurements in Breast Cancer. Tomography 2020, 6, 170-176. https://doi.org/10.18383/j.tom.2020.00002

AMA Style

Whisenant JG, Williams JM, Kang H, Arlinghaus LR, Abramson RG, Abramson VG, Fakhoury K, Chakravarthy AB, Yankeelov TE. Quantitative Comparison of Prone and Supine PERCIST Measurements in Breast Cancer. Tomography. 2020; 6(2):170-176. https://doi.org/10.18383/j.tom.2020.00002

Chicago/Turabian Style

Whisenant, Jennifer G., Jason M. Williams, Hakmook Kang, Lori R. Arlinghaus, Richard G. Abramson, Vandana G. Abramson, Kareem Fakhoury, A. Bapsi Chakravarthy, and Thomas E. Yankeelov. 2020. "Quantitative Comparison of Prone and Supine PERCIST Measurements in Breast Cancer" Tomography 6, no. 2: 170-176. https://doi.org/10.18383/j.tom.2020.00002

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