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Neoadjuvant chemotherapy in breast cancer: early response prediction with quantitative MR imaging and spectroscopy

A prospective study was undertaken in women undergoing neoadjuvant chemotherapy for locally advanced breast cancer in order to determine the ability of quantitative magnetic resonance imaging (MRI) and proton spectroscopy (MRS) to predict ultimate tumour response (percentage decrease in volume) or t...

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Autores principales: Manton, D J, Chaturvedi, A, Hubbard, A, Lind, M J, Lowry, M, Maraveyas, A, Pickles, M D, Tozer, D J, Turnbull, L W
Formato: Texto
Lenguaje:English
Publicado: Nature Publishing Group 2006
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2361138/
https://www.ncbi.nlm.nih.gov/pubmed/16465174
http://dx.doi.org/10.1038/sj.bjc.6602948
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author Manton, D J
Chaturvedi, A
Hubbard, A
Lind, M J
Lowry, M
Maraveyas, A
Pickles, M D
Tozer, D J
Turnbull, L W
author_facet Manton, D J
Chaturvedi, A
Hubbard, A
Lind, M J
Lowry, M
Maraveyas, A
Pickles, M D
Tozer, D J
Turnbull, L W
author_sort Manton, D J
collection PubMed
description A prospective study was undertaken in women undergoing neoadjuvant chemotherapy for locally advanced breast cancer in order to determine the ability of quantitative magnetic resonance imaging (MRI) and proton spectroscopy (MRS) to predict ultimate tumour response (percentage decrease in volume) or to detect early response. Magnetic resonance imaging and MRS were carried out before treatment and after the second of six treatment cycles. Pharmacokinetic parameters were derived from T(1)-weighted dynamic contrast-enhanced MRI, water apparent diffusion coefficient (ADC) was measured, and tissue water : fat peak area ratios and water T(2) were measured using unsuppressed one-dimensional proton spectroscopic imaging (30 and 135 ms echo times). Pharmacokinetic parameters and ADC did not detect early response; however, early changes in water : fat ratios and water T(2) (after cycle two) demonstrated substantial prognostic efficacy. Larger decreases in water T(2) accurately predicted final volume response in 69% of cases (11/16) while maintaining 100% specificity and positive predictive value. Small/absent decreases in water : fat ratios accurately predicted final volume non-response in 50% of cases (3/6) while maintaining 100% sensitivity and negative predictive value. This level of accuracy might permit clinical application where early, accurate prediction of non-response would permit an early change to second-line treatment, thus sparing patients unnecessary toxicity, psychological morbidity and delay of initiation of effective treatment.
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spelling pubmed-23611382009-09-10 Neoadjuvant chemotherapy in breast cancer: early response prediction with quantitative MR imaging and spectroscopy Manton, D J Chaturvedi, A Hubbard, A Lind, M J Lowry, M Maraveyas, A Pickles, M D Tozer, D J Turnbull, L W Br J Cancer Molecular Diagnostics A prospective study was undertaken in women undergoing neoadjuvant chemotherapy for locally advanced breast cancer in order to determine the ability of quantitative magnetic resonance imaging (MRI) and proton spectroscopy (MRS) to predict ultimate tumour response (percentage decrease in volume) or to detect early response. Magnetic resonance imaging and MRS were carried out before treatment and after the second of six treatment cycles. Pharmacokinetic parameters were derived from T(1)-weighted dynamic contrast-enhanced MRI, water apparent diffusion coefficient (ADC) was measured, and tissue water : fat peak area ratios and water T(2) were measured using unsuppressed one-dimensional proton spectroscopic imaging (30 and 135 ms echo times). Pharmacokinetic parameters and ADC did not detect early response; however, early changes in water : fat ratios and water T(2) (after cycle two) demonstrated substantial prognostic efficacy. Larger decreases in water T(2) accurately predicted final volume response in 69% of cases (11/16) while maintaining 100% specificity and positive predictive value. Small/absent decreases in water : fat ratios accurately predicted final volume non-response in 50% of cases (3/6) while maintaining 100% sensitivity and negative predictive value. This level of accuracy might permit clinical application where early, accurate prediction of non-response would permit an early change to second-line treatment, thus sparing patients unnecessary toxicity, psychological morbidity and delay of initiation of effective treatment. Nature Publishing Group 2006-02-13 2006-02-07 /pmc/articles/PMC2361138/ /pubmed/16465174 http://dx.doi.org/10.1038/sj.bjc.6602948 Text en Copyright © 2006 Cancer Research UK https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material.If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/.
spellingShingle Molecular Diagnostics
Manton, D J
Chaturvedi, A
Hubbard, A
Lind, M J
Lowry, M
Maraveyas, A
Pickles, M D
Tozer, D J
Turnbull, L W
Neoadjuvant chemotherapy in breast cancer: early response prediction with quantitative MR imaging and spectroscopy
title Neoadjuvant chemotherapy in breast cancer: early response prediction with quantitative MR imaging and spectroscopy
title_full Neoadjuvant chemotherapy in breast cancer: early response prediction with quantitative MR imaging and spectroscopy
title_fullStr Neoadjuvant chemotherapy in breast cancer: early response prediction with quantitative MR imaging and spectroscopy
title_full_unstemmed Neoadjuvant chemotherapy in breast cancer: early response prediction with quantitative MR imaging and spectroscopy
title_short Neoadjuvant chemotherapy in breast cancer: early response prediction with quantitative MR imaging and spectroscopy
title_sort neoadjuvant chemotherapy in breast cancer: early response prediction with quantitative mr imaging and spectroscopy
topic Molecular Diagnostics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2361138/
https://www.ncbi.nlm.nih.gov/pubmed/16465174
http://dx.doi.org/10.1038/sj.bjc.6602948
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