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

Jensen, Line R.; Garzón, Benjamín; Heldahl, Mariann Gjervik; Bathen, Tone Frost; Lundgren, Steinar; Gribbestad, Ingrid S.

doi:10.1002/jmri.22726

Cited by 63 publications

(53 citation statements)

References 41 publications

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“…Mean tumor ADC increased significantly as measured by both techniques after 3 weeks of therapy, which is in agreement with other studies of breast cancer patients that have reported significant increases in tumor ADC of a similar magnitude at early treatment time points (24) (6). …”

Section: Discussionsupporting

confidence: 91%

“…A similar relationship between pretreatment tumor ADC and tumor volume change was also found by Iacconi et al (10). However, other studies have found no correlation between pretreatment tumor ADC and final tumor volume change or pathologic complete response (4,13,24). As has been noted, the discrepancies in findings may be due to differences in DWI acquisition parameters, tumor ROI selection, and how tumor volume is calculated (26).…”

Section: Discussionmentioning

confidence: 82%

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High-Resolution Diffusion-Weighted Imaging for Monitoring Breast Cancer Treatment Response

Wilmes¹,

McLaughlin²,

Newitt³

et al. 2013

Academic Radiology

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Rationale and Objectives The aim of this work was to compare a high-resolution diffusion-weighted imaging (HR-DWI) acquisition (voxel size = 4.8 mm3) to a standard diffusion-weighted imaging (STD-DWI) acquisition (voxel size = 29.3 mm3) for monitoring neoadjuvant therapy-induced changes in breast tumors. Materials and Methods Nine women with locally advanced breast cancer were imaged with both HR-DWI and STD-DWI before and after 3 weeks (early treatment) of neoadjuvant taxane-based treatment. Tumor apparent diffusion coefficient (ADC) metrics (mean and histogram percentiles) from both DWI methods were calculated, and their relationship to tumor volume change after 12 weeks of treatment (posttreatment) measured by dynamic contrast enhanced magnetic resonance imaging was evaluated with a Spearman’s rank correlation. Results The HR-DWI pretreatment 15th percentile tumor ADC (P = .03) and early treatment 15th, 25th, and 50th percentile tumor ADCs (P = .008, .010, .04, respectively) were significantly lower than the corresponding STD-DWI percentile ADCs. The mean tumor HR-ADC was significantly lower than STD-ADC at the early treatment time point (P = .02), but not at the pretreatment time point (P = .07). A significant early treatment increase in tumor ADC was found with both methods (P < .05). Correlations between HR-DWI tumor ADC and posttreatment tumor volume change were higher than the STD-DWI correlations at both time points and the lower percentile ADCs had the strongest correlations. Conclusion These initial results suggest that the HR-DWI technique has potential for improving characterization of low tumor ADC values over STD-DWI and that HR-DWI may be of value in evaluating tumor change with treatment.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 82%

High-Resolution Diffusion-Weighted Imaging for Monitoring Breast Cancer Treatment Response

Wilmes¹,

McLaughlin²,

Newitt³

et al. 2013

Academic Radiology

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“…The DW-MRI approach is a highly sensitive tool that has demonstrated the potential to serve as an in vivo biomarker for early detection of tumor response prior to anatomic tumor size changes [36,42–46]. Significant changes in tumor tissue water mobility have been detected in breast, brain, prostate and GI tract tumors following radiation and/or chemotherapy [36,42–46].…”

Section: Discussionmentioning

confidence: 99%

Rapid Dramatic Alterations to The Tumor Microstructure in Pancreatic Cancer Following Irreversible Electroporation Ablation

Zhang

Procissi

et al. 2014

Nanomedicine

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Aim NanoKnife® (Angiodynamics, Inc., NY, USA) or irreversible electroporation (IRE) is a newly available ablation technique to induce the formation of nanoscale pores within the cell membrane in targeted tissues. The purpose of this study was to elucidate morphological alterations following 30 min of IRE ablation in a mouse model of pancreatic cancer. Materials & methods Immunohistochemistry markers were compared with diffusion-weighted MRI apparent diffusion coefficient measurements before and after IRE ablation. Results Immunohistochemistry apoptosis index measurements were significantly higher in IRE-treated tumors than in controls. Rapid tissue alterations after 30 min of IRE ablation procedures (structural and morphological alterations along with significantly elevated apoptosis markers) were consistently observed and well correlated to apparent diffusion coefficient measurements. Discussion This imaging assay offers the potential to serve as an in vivo biomarker for noninvasive detection of tumor response following IRE ablation.

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“…The coupling of the diffusion imaging with the established morphological MRI provides superior evaluation of response to NAC compared with morphological MRI alone [68]. 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 [69, 70]. ADC measured after four cycles of NAC was shown to be a strong independent predictor of pCR [71].…”

Section: Early Response Predictors Using Different Mr Imaging Methodsmentioning

confidence: 99%

Clinical Application of Magnetic Resonance Imaging in Management of Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

Chen

2013

BioMed Research International

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Neoadjuvant chemotherapy (NAC), also termed primary, induction, or preoperative chemotherapy, is traditionally used to downstage inoperable breast cancer. In recent years it has been increasingly used for patients who have operable cancers in order to facilitate breast-conserving surgery, achieve better cosmetic outcome, and improve prognosis by reaching pathologic complete response (pCR). Many studies have demonstrated that magnetic resonance imaging (MRI) can assess residual tumor size after NAC, and that provides critical information for planning of the optimal surgery. NAC also allows for timely adjustment of administered drugs based on response, so ineffective regimens could be terminated early to spare patients from unnecessary toxicity while allowing other effective regimens to work sooner. This review article summarizes the clinical application of MRI during NAC. The use of different MR imaging methods, including dynamic contrast-enhanced MRI, proton MR spectroscopy, and diffusion-weighted MRI, to monitor and evaluate the NAC response, as well as how changes of parameters measured at an early time after initiation of a drug regimen can predict final treatment outcome, are reviewed. MRI has been proven a valuable tool and will continue to provide important information facilitating individualized image-guided treatment and personalized management for breast cancer patients undergoing NAC.

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

Cited by 63 publications

References 41 publications

High-Resolution Diffusion-Weighted Imaging for Monitoring Breast Cancer Treatment Response

High-Resolution Diffusion-Weighted Imaging for Monitoring Breast Cancer Treatment Response

Rapid Dramatic Alterations to The Tumor Microstructure in Pancreatic Cancer Following Irreversible Electroporation Ablation

Clinical Application of Magnetic Resonance Imaging in Management of Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

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