Monitoring Breast Cancer Response to Neoadjuvant Systemic Chemotherapy Using Parametric Contrast-Enhanced MRI: A Pilot Study

Chou, Chen Pin; Wu, Ming Ting; Chang, Hong; Lo, Yu Shin; Pan, Huay‐Ben; Degani, Hadassa; Furman‐Haran, Edna

doi:10.1016/j.acra.2007.02.005

Cited by 48 publications

(40 citation statements)

References 39 publications

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“…Tc-labeled Annexin V in conjunction with SPECT imaging was also predictive of treatment response in a wide variety of tumors. [64][65][66] For breast cancer chemotherapy, both DCE-MRI 67 and optical spectroscopy 68 have proven effective in the neoadjuvant setting. The fundamental problem with all of these methods, though, is quantitative assessment of log kill.…”

Section: Image-guided Chemotherapymentioning

confidence: 99%

“…The main limitation to x-ray imaging is that exogenous contrast agents must have a high atomic number and be at exceptionally high concentrations to attenuate x-rays. The nontargeted, exogenous agents that are currently used clinically are injected at molar 67 Ga, gallium 67; PET, positron emission tomography; ICG, indocyanine green; NIR, near-infrared. ‫ء‬ After conjugation of a targeting molecule to a contrast agent or radiotracer, final hydrodynamic diameter increases proportionally.…”

Section: X-ray Imagingmentioning

confidence: 99%

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New Technologies for Human Cancer Imaging

Frangioni

2008

JCO

698

554

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Despite technical advances in many areas of diagnostic radiology, the detection and imaging of human cancer remains poor. A meaningful impact on cancer screening, staging, and treatment is unlikely to occur until the tumor-to-background ratio improves by three to four orders of magnitude (ie, 10 3 -to 10 4 -fold), which in turn will require proportional improvements in sensitivity and contrast agent targeting. This review analyzes the physics and chemistry of cancer imaging and highlights the fundamental principles underlying the detection of malignant cells within a background of normal cells. The use of various contrast agents and radiotracers for cancer imaging is reviewed, as are the current limitations of ultrasound, x-ray imaging, magnetic resonance imaging (MRI), single-photon emission computed tomography, positron emission tomography (PET), and optical imaging. Innovative technologies are emerging that hold great promise for patients, such as positron emission mammography of the breast and spectroscopy-enhanced colonoscopy for cancer screening, hyperpolarization MRI and time-of-flight PET for staging, and ion beam-induced PET scanning and near-infrared fluorescence-guided surgery for cancer treatment. This review explores these emerging technologies and considers their potential impact on clinical care. Finally, those cancers that are currently difficult to image and quantify, such as ovarian cancer and acute leukemia, are discussed. J Clin

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Section: Image-guided Chemotherapymentioning

confidence: 99%

Section: X-ray Imagingmentioning

confidence: 99%

New Technologies for Human Cancer Imaging

Frangioni

2008

JCO

698

554

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“…Although this equation should be updated with results of direct long-term monitoring of tumor size and histologic analysis in preclinical and clinical studies to follow, it is the prototype for future versions. In addition, the equation could be further upgraded by incorporating other noninvasive indicators of therapeutic response, such as K trans calculated at dynamic contrast material-enhanced MR imaging (36,37) or standardized uptake value at fluorine 18 fluorodeoxyglucose positron emission tomography (38), for improved accuracy in the assessment of early response to this and other novel targeted therapies. …”

Section: Experimental Studies: Apoptosis Therapy In Breast Tumor Xenomentioning

confidence: 99%

Breast Tumor Xenografts: Diffusion-weighted MR Imaging to Assess Early Therapy with Novel Apoptosis-Inducing Anti-DR5 Antibody

Kim

Morgan²,

Zeng³

et al. 2008

Radiology

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Purpose:To measure the early therapeutic response to a novel apoptosis-inducing antibody, TRA-8, by using diffusionweighted magnetic resonance (MR) imaging in a mouse breast cancer model. Materials and Methods:Animal experiments had institutional animal care and use committee approval. Four groups of nude mice bearing luciferase-positive breast tumors (four to five mice with eight to 10 tumors per group) were injected intravenously with 0 mg (group 1), 0.025 mg (group 2), 0.100 mg (group 3), or 0.200 mg (group 4) of TRA-8 on days 0 and 3. Diffusion-weighted imaging, anatomic MR imaging, and bioluminescence imaging were performed on days 0, 3, and 6 before dosing. Averaged apparent diffusion coefficients (ADCs) for both whole tumor volume and a 1-mm peripheral tumor shell were calculated and were compared with tumor volume and living tumor cell changes. After imaging at day 6, proliferating and apoptotic cell densities were measured with Ki67 and terminal deoxynucleotidyl transferase mediated dUTP nick end labeling, or TUNEL, staining, respectively, and were compared with cleaved caspase-3 density. Results:The ADC increase at day 3 was dependent on TRA-8 dose level, averaging 6% Ϯ 3 (standard error of mean), 19% Ϯ 4, 14% Ϯ 4, and 34% Ϯ 7 in the whole tumor volume and 1% Ϯ 2, 9% Ϯ 5, 13% Ϯ 5, and 30% Ϯ 8 in the outer 1-mm tumor shell only for groups 1, 2, 3, and 4, respectively. The ADC increase in group 4 was significantly higher (P ϭ .0008 and P ϭ .0189 for whole tumor volume and peripheral region, respectively) than that in group 1 on day 3, whereas tumor size did not significantly differ. At day 3, the dose-dependent ADC increases were linearly proportional to apoptotic cell and cleaved caspase-3 densities and were inversely proportional to the density of cells showing Ki67 expression. Conclusion:Diffusion-weighted imaging enabled measurement of early breast tumor response to TRA-8 treatment, prior to detectable tumor shrinkage, providing an effective mechanism to noninvasively monitor TRA-8 efficacy.

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“…To date, several studies have focused on measurements of parameters related to cancer metabolism and blood flow after few cycles of chemotherapy, i.e., after several weeks. 39,[41][42][43][44][45] The present study has focused on daily measurements within the first week. The observations of blood flow changes are the first of their kind during early stage chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Diffuse optical monitoring of blood flow and oxygenation in human breast cancer during early stages of neoadjuvant chemotherapy

et al. 2007

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We combine diffuse optical spectroscopy (DOS) and diffuse correlation spectroscopy (DCS) to noninvasively monitor early hemodynamic response to neoadjuvant chemotherapy in a breast cancer patient. The potential for early treatment monitoring is demonstrated. Within the first week of treatment (day 7) DOS revealed significant changes in tumor/normal contrast compared to pretreatment (day 0) tissue concentrations of deoxyhemoglobin (rctHHb T/N =69±21%), oxyhemoglobin (rctO 2 Hb T/N =73±25%), total hemoglobin (rctTHb T/N =72±17%), and lipid concentration (rctLipid T/N =116±13%). Similarly, DCS found significant changes in tumor/normal blood flow contrast (rBF T/N =75±7% on day 7 with respect to day 0). Our observation suggest the combination of DCS and DOS enhances treatment monitoring compared to either technique alone. The hybrid approach also enables construction of indices reflecting tissue metabolic rate of oxygen, which may provide new insights about therapy mechanisms. Abstract. We combine diffuse optical spectroscopy ͑DOS͒ and diffuse correlation spectroscopy ͑DCS͒ to noninvasively monitor early hemodynamic response to neoadjuvant chemotherapy in a breast cancer patient. The potential for early treatment monitoring is demonstrated. Within the first week of treatment ͑day 7͒ DOS revealed significant changes in tumor/normal contrast compared to pretreatment ͑day 0͒ tissue concentrations of deoxyhemoglobin ͑rctHHb T/N = 69± 21% ͒, oxyhemoglobin ͑rctO 2 Hb T/N = 73± 25% ͒, total hemoglobin ͑rctTHb T/N = 72± 17% ͒, and lipid concentration ͑rctLipid T/N = 116± 13% ͒. Similarly, DCS found significant changes in tumor/ normal blood flow contrast ͑rBF T/N =75±7% on day 7 with respect to day 0͒. Our observations suggest the combination of DCS and DOS enhances treatment monitoring compared to either technique alone. The hybrid approach also enables construction of indices reflecting tissue metabolic rate of oxygen, which may provide new insights about therapy mechanisms. © 2007 Society of Photo-Optical Instrumentation Engineers.

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Monitoring Breast Cancer Response to Neoadjuvant Systemic Chemotherapy Using Parametric Contrast-Enhanced MRI: A Pilot Study

Cited by 48 publications

References 39 publications

New Technologies for Human Cancer Imaging

New Technologies for Human Cancer Imaging

Breast Tumor Xenografts: Diffusion-weighted MR Imaging to Assess Early Therapy with Novel Apoptosis-Inducing Anti-DR5 Antibody

Diffuse optical monitoring of blood flow and oxygenation in human breast cancer during early stages of neoadjuvant chemotherapy

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