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THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING

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The Quarterly Journal of Nuclear Medicine 2001 September;45(3):257-68

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Evaluation of therapy response in breast and ovarian cancer patients by positron emission tomography (PET)

Baum R. P., Przetak Ch.

From the Zentralklinik Bad Berka Clinic of Nuclear Medicine, Center for PET, Bad Berka Germany


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Posi­tron emis­sion tomog­raphy (PET) has the poten­tial to con­tribute sig­nif­i­cantly to treat­ment plan­ning and to the eval­u­a­tion of ­response to ­therapy in ­patients ­with ­cancer. For dis­ease recur­rence PET ­imaging pro­vides infor­ma­tion non-inva­sively. The ­final ­goal is to bio­log­i­cally char­ac­terize an indi­vidual ­patient’s ­tumor and to pre­dict the ­response to treat­ment at the ear­liest pos­sible ­time. ­Since the devel­op­ment of neo­ad­ju­vant chem­o­therapy, PET has ­been ­proved to be the ­most sen­si­tive and accu­rate ­imaging tech­nique for ­early ­therapy ­response eval­u­a­tion of ­breast ­tumors. Quan­ti­ta­tive and/or ­semi-quan­ti­ta­tive PET ­studies ­yield val­u­able infor­ma­tion in ­breast ­cancer ­regarding prog­nosis and ­response to chem­o­hor­mon­therapy in a ­timely ­fashion. In ­ovarian ­cancer, up to now ­only few ­studies ­have ­been per­formed ­applying PET tech­niques for the eval­u­a­tion of treat­ment ­response. ­These pre­lim­i­nary ­studies indi­cate ­that ­serial assess­ment of ­tumor metab­olism by FDG-PET ­early ­during effec­tive chem­o­therapy may pre­dict sub­se­quent ­response to ­such ­therapy. PET ­studies can be ­repeated ­without any ­side-­effects and ­with low radi­a­tion expo­sure and ­results can be ­directly cor­re­lated ­with clin­ical labor­a­tory ­data and his­tology. The ­role of PET in the con­text of ­patient man­age­ment and the cost-ef­fec­tive­ness of ­this ­approach ­needs fur­ther eval­u­a­tion. ­Therapy mon­i­toring by PET ­could ­help to opti­mize neo­ad­ju­vant ­therapy pro­to­cols and to ­avoid inef­fec­tive pre­op­er­a­tive ­therapy in non-­responders, but ­this has to be ­proven in a ­larger ­number of ­patients and in dif­ferent neo­ad­ju­vant set­tings ­such as chem­o­therapy, radi­a­tion ­therapy, ­hormone ­therapy or a com­bi­na­tion of ­these.

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