HER2-targeted PET/CT in breast cancer: a systematic review of lesion-level concordance with pathology.
Siri Af Burén, Nour Susaeg Romdhani, Gary Ulaner et al.
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In 30 seconds
This systematic review assessed the concordance of HER2-targeted PET/CT with pathology in breast cancer, analyzing 195 lesions from ten studies. The review found that sensitivity was 75% for affinity protein-based tracers and 100% for monoclonal antibody-based tracers, indicating moderate-to-good agreement with biopsy results.
Key findings
- Sensitivity for affinity protein-based tracers was 75% [95% CI, 65-83%].
- Monoclonal antibody-based tracers achieved 100% sensitivity [95% CI, 59-100%].
- Specificity for affinity protein-based tracers was 79% [95% CI, 68-87%].
- Most false-positive lesions were HER2-low rather than HER2-zero (≥86%).
Why it matters
Understanding the concordance between HER2-targeted PET/CT and pathology can enhance treatment selection in breast cancer, particularly given the heterogeneity of HER2 expression. This may lead to more personalized therapeutic strategies.
What to keep in mind
The findings are limited by small study populations, selective lesion verification, and heterogeneous imaging methodologies.