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Breast Cancer Research and Treatment

, Volume 91, Issue 1, pp 1–10 | Cite as

Role of dynamic contrast enhanced MRI in monitoring early response of locally advanced breast cancer to neoadjuvant chemotherapy

  • Martin D. Pickles
  • Martin Lowry
  • David J. Manton
  • Peter Gibbs
  • Lindsay W. Turnbull
Report

Abstract

Neoadjuvant chemotherapy has become the standard treatment for patients with locally advanced breast cancer; however a technique that can accurately differentiate responders from non-responders at an early time point during treatment has still to be identified. The purpose of this work was to evaluate the ability of pharmacokinetically modelled dynamic contrast-enhanced MRI data to predict and monitor response of patients diagnosed with locally advanced breast cancer to neoadjuvant chemotherapy, at an early time point during treatment. Sixty-eight patients with histology proven breast cancer underwent MRI examination prior to treatment, early during treatment and following the final cycle of chemotherapy. A two compartment pharmacokinetic model provided the kinetic parameters transfer constant (Ktrans), rate constant (Kep) and extracellular extravascular space (Ve) for a region of interest encompassing the whole lesion (ROIwhole) and a 3 × 3 pixel ‘hot-spot’ showing the greatest mean maximum percentage enhancement from within that region (ROIhs). Following treatment 48 patients were classified as responders and 20 as non-responders based on total tumour volume reduction. Tumour volume changes between the pre-treatment and early treatment time points demonstrated differences between responders and non-responders with percentage change revealing the most significant result (p < 0.001). Analysis based on ROIhsprovided more statistically significant differences between responders and non-responders then ROIwhole analysis. ROIhs analysis demonstrated differences between responders and non-responders both prior to and early during treatment. A highly significant reduction in both Ktrans and Kep (p < 0.001) was noted for responders between the pre-treatment and early treatment time points, while Ve significantly increased during the same time period for non-responders (p < 0.001). Quantification of dynamic contrast enhancement parameters provides a potential means for differentiating responders from non-responders early during their treatment, thereby allowing a prompt change in treatment if necessary.

Keywords

breast cancer Kep Ktrans neoadjuvant pharmacokinetic response Ve 

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Copyright information

© Springer 2005

Authors and Affiliations

  • Martin D. Pickles
    • 1
    • 2
  • Martin Lowry
    • 1
  • David J. Manton
    • 1
  • Peter Gibbs
    • 1
  • Lindsay W. Turnbull
    • 1
  1. 1.Post-graduate Medical School, Division of Cancer, Centre for Magnetic Resonance InvestigationsUniversity of HullUK
  2. 2.Centre for Magnetic Resonance InvestigationsHull Royal InfirmaryHullUK

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