期刊
EUROPEAN RADIOLOGY
卷 27, 期 7, 页码 2726-2736出版社
SPRINGER
DOI: 10.1007/s00330-016-4630-x
关键词
Breast carcinoma; Diffusion-weighted MRI; Neoadjuvant treatment; Quantitative evaluation; Tumour biomarkers
资金
- Addenbrooke's Charitable Trust
- NIHR comprehensive Biomedical Research Centre (BRC)
- Experimental Cancer Medicine Centre (ECMC)
- Addenbrookes Charitable Trust
- Cancer Research UK [11562, 16465, 22310] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0515-10067] Funding Source: researchfish
To assess the feasibility of the mono-exponential, bi-exponential and stretched-exponential models in evaluating response of breast tumours to neoadjuvant chemotherapy (NACT) at 3 T. Thirty-six female patients (median age 53, range 32-75 years) with invasive breast cancer undergoing NACT were enrolled for diffusion-weighted MRI (DW-MRI) prior to the start of treatment. For assessment of early response, changes in parameters were evaluated on mid-treatment MRI in 22 patients. DW-MRI was performed using eight b values (0, 30, 60, 90, 120, 300, 600, 900 s/mm(2)). Apparent diffusion coefficient (ADC), tissue diffusion coefficient (D (t)), vascular fraction (AE'), distributed diffusion coefficient (DDC) and alpha (alpha) parameters were derived. Then t tests compared the baseline and changes in parameters between response groups. Repeatability was assessed at inter- and intraobserver levels. All patients underwent baseline MRI whereas 22 lesions were available at mid-treatment. At pretreatment, mean diffusion coefficients demonstrated significant differences between groups (p < 0.05). At mid-treatment, percentage increase in ADC and DDC showed significant differences between responders (49 % and 43 %) and non-responders (21 % and 32 %) (p = 0.03, p = 0.04). Overall, stretched-exponential parameters showed excellent repeatability. DW-MRI is sensitive to baseline and early treatment changes in breast cancer using non-mono-exponential models, and the stretched-exponential model can potentially monitor such changes. aEuro cent Baseline diffusion coefficients demonstrated significant differences between complete pathological responders and non-responders. aEuro cent Increase in ADC and DDC at mid-treatment can discriminate responders and non-responders. aEuro cent The AE' fraction at mid-treatment decreased in responders whereas increased in non-responders. aEuro cent The mono- and stretched-exponential models showed excellent inter- and intrarater repeatability. aEuro cent Treatment effects can potentially be assessed by non-mono-exponential diffusion models.
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