Diffusion changes precede size reduction in neoadjuvant treatment of breast cancer

Pickles, Martin D.; Gibbs, Peter; Lowry, Martin; Turnbull, Lindsay W.

doi:10.1016/j.mri.2005.11.005

Cited by 352 publications

(279 citation statements)

References 18 publications

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“…This finding is in agreement with other studies showing that changes in ADC can be found after only one cycle of NAC, with even a more pronounced increase after two cycles (8,10,33). This result is promising, because the implication is that ADC may be considered as a direct measure of treatment effects to chemotherapy.…”

Section: Discussionsupporting

confidence: 92%

“…An effective treatment may change the vascular properties, thus influencing the enhancement kinetics. Diffusion-weighted MRI (DW-MRI) has also been investigated as a possible predictive marker for treatment response (8). Signal attenuation in DW-MRI is dependent on the natural diffusion of water molecules in tissue, restricted by structures such as cell membranes and macromolecules.…”

mentioning

confidence: 99%

“…In tumors, an effective treatment causes cell death and leads to changes in tumor and intracellular structure, thus increasing the ADC (9). The correlation between ADC values and treatment response has been investigated, and studies show an early increase in ADC after only one or two cycles of NAC (8,10). Guidelines for the use of DW-MRI as a cancer biomarker have been suggested, and emphasize the need for both validation and assessment of reliability of this method in oncologic imaging (11).…”

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confidence: 99%

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Diffusion‐weighted and dynamic contrast‐enhanced MRI in evaluation of early treatment effects during neoadjuvant chemotherapy in breast cancer patients

Jensen¹,

Garzón²,

Heldahl³

et al. 2011

Magnetic Resonance Imaging

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Purpose: To use dynamic contrast-enhanced (DCE) and diffusion-weighted (DW) MRI at 3 Tesla (T) for early evaluation of treatment effects in breast cancer patients undergoing neoadjuvant chemotherapy (NAC), and assess the reliability of DW-MRI.Materials and Methods: DW-and DCE-MRI acquisitions of 15 breast cancer patients were performed before and after one cycle of NAC. MRI tumor diameter and volume, apparent diffusion coefficient (ADC) and kinetic parameters (K trans , v e ) were derived. The reliability of ADC before NAC was assessed. Changes in MRI parameters after NAC were analyzed, and logistic regression analysis was used to find the best predictors for pathologic response. Results:The reliability for ADC values was high, with intraclass correlation coefficient of 0.84 (P ¼ 0.001). After one cycle of NAC, MRI tumor diameter (8%, P ¼ 0.005) and tumor volume (30%, P ¼ 0.008) was reduced for all patients, while ADC mean values increased (0.12 mm 2 /s, P ¼ 0.008). The best predictor for treatment response was a change in MRI tumor diameter with mean error rate of 0.167 (13% for responders, 5% for nonresponders, P ¼ 0.291).Conclusion: Changes in MRI derived tumor diameter and ADC after only one cycle of NAC could provide a valuable tool for early evaluation of treatment effects in breast cancer patients.

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Section: Discussionsupporting

confidence: 92%

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confidence: 99%

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confidence: 99%

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Diffusion‐weighted and dynamic contrast‐enhanced MRI in evaluation of early treatment effects during neoadjuvant chemotherapy in breast cancer patients

Jensen¹,

Garzón²,

Heldahl³

et al. 2011

Magnetic Resonance Imaging

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“…Recent publications describe an increase in specificity with the use of diffusion-weighted imaging (DWI) [6 -8]. Moreover, DWI can be useful for the detection [9], assessment [10 -14] or treatment response monitoring [15,16] of breast cancer. However, when using DWI, the applied pulse sequences, b-values and approach (before or after contrast administration, selected slices or complete volumes) differ in most publications [17].…”

mentioning

confidence: 99%

Diffusion-Weighted MR Imaging of Benign and Malignant Breast Lesions Before and After Contrast Enhancement

Janka

Hammon

Geppert

et al. 2013

Fortschr Röntgenstr

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Mamma 130Janka R et al. 50, 400 und 800) wurde vor und nach KM-Gabe gemessen und die entsprechenden ADC-Werte der Läsionen verglichen. Vor der Berechnung der ADC-Werte wurden die Läsionen bezüglich ihrer konstanten Lokalisation in den diffusionsgewichteten Sequenzen analysiert. Ergebnisse: Die mittlere Größe der Läsionen war 1,5 ± 0,8 cm. Auf der Basis der b50-und b400-Messung betrug der durchschnittliche ADC-Wert der benignen Läsionen 1,89 ± 0,30 × 10 -3 mm 2 /s vor und 1,85 ± 0,28 × 10 -3 mm 2 /s nach KM-Gabe. Die entsprechenden Werte für zwei muzinöse Karzinome betrugen 1,88 × 10 -3 mm 2 /s und 1,81 × 10 3 mm 2 /s und für die übrigen malignen Läsionen 1,00 ± 0,18 × 10 -3 mm 2 /s und 0,88 ± 0,21 × 10 -3 mm 2 . Auf der Basis der b50-, b400-und b800-Messung betrug der durchschnittliche ADC-Wert der benignen Läsionen 1,99 ± 0,37 × 10 -3 mm 2 /s vor und 1,97 ± 0,30 × 10 -3 mm 2 /s nach KM-Gabe. Der mittlere ADC-Wert der malignen Läsionen betrug 0,90 ± 0,14 × 10 -3 mm 2 /s vor und 0,80 ± 0,14 × 10 -3 mm 2 /s nach KM-Gabe. Während der ADC-Wert der gutartigen Läsionen durch das Kontrastmittel nicht signifikant beinflusst wurde, war er bei den malignen Läsionen nach Kontrastmittelgabe signifikant niedriger. Abstract !Purpose: Many publications describe the use of diffusion-weighted imaging (DWI) in breast MRI. This article addresses the question of when to apply the DWI sequence in the course of the scan protocol. The effect of T1-shortening contrast media (CM) on the ADC values of breast lesions is investigated. Materials and Methods: Data were acquired on a 1.5 T scanner. 60 patients with 79 lesions (20 benign, 59 malignant) were included. The DWI sequence (4 mm slice thickness, b-values: 50, 400, 800) was applied before and after CM administration. Before calculating the ADC map, the b50, b400 and b800 series were analyzed concerning lesion displacement. ADC values before and after CM application were compared.

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“…Malignant tumors have lower ADC values than normal tissue or benign lesions (19) due to higher cellularity, disorganized tissue, and increased extracellular space tortuosity (20). Successful cancer therapies have been associated with an early increase in ADC in animal xenograft models and human tumors (21)(22)(23)(24)(25). DW-MRI may also reveal differences between necrotic and viable tissues.…”

mentioning

confidence: 99%

In vivo MRI and histopathological assessment of tumor microenvironment in luminal‐like and basal‐like breast cancer xenografts

Huuse

Moestue

Lindholm

et al. 2011

Magnetic Resonance Imaging

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Purpose: To explore tumor pathophysiology with special attention to the microenvironment in two molecular subtypes of human breast cancer using in vivo magnetic resonance imaging (MRI) and histopathology. The impact of tumor growth, size, and the influence of estradiol were also investigated. Materials and Methods:Two orthotopic and directly transplanted human breast cancer models representing luminal-like and basal-like molecular subtypes were characterized by dynamic contrast-enhanced MRI and diffusion-weighted MRI. Ex vivo measurements of vascularization, hypoxia, mitoses, and the level of VEGF activations were associated with the calculated in vivo MRI parameters of the tumors. Results:The vascular permeability and perfusion (K trans ) was significantly higher in basal-like compared to luminal-like tumors. These findings were confirmed by a 4-fold higher proliferating microvessel density (pMVD) in basal-like tumors, reflecting the difference in aggressiveness between the subtypes. No effect of tumor growth was observed during 6 days of growth in any of the models; however, large tumors had lower K trans , higher extracellular extravascular volume fraction (v e ), and more hypoxia than medium-sized tumors. Estradiol withdrawal induced increased K trans , v e , and tumor water diffusion (ADC) in luminal-like tumors, corresponding to increased VEGFR2 activation, which is likely to cause increased tumor vessel permeability.Conclusion: These novel data confirm the potential of functional MRI methods to map histopathologically proven changes in breast tumor vasculature and microenvironment in vivo.

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Diffusion changes precede size reduction in neoadjuvant treatment of breast cancer

Cited by 352 publications

References 18 publications

Diffusion‐weighted and dynamic contrast‐enhanced MRI in evaluation of early treatment effects during neoadjuvant chemotherapy in breast cancer patients

Diffusion‐weighted and dynamic contrast‐enhanced MRI in evaluation of early treatment effects during neoadjuvant chemotherapy in breast cancer patients

Diffusion-Weighted MR Imaging of Benign and Malignant Breast Lesions Before and After Contrast Enhancement

In vivo MRI and histopathological assessment of tumor microenvironment in luminal‐like and basal‐like breast cancer xenografts

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