Early Changes in Functional Dynamic Magnetic Resonance Imaging Predict for Pathologic Response to Neoadjuvant Chemotherapy in Primary Breast Cancer Export

@article{citeulike:3757285, abstract = {10.1158/1078-0432.CCR-07-4310 Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) allows noninvasive, measurements of tissue microvessel perfusion and permeability. We examined whether DCE-MRI done after two cycles of neoadjuvant chemotherapy could predict final clinical and pathologic response in primary breast cancers. Thirty-seven patients with primary breast cancer, due to receive six cycles of neoadjuvant 5-fluorouracil, epirubicin and cyclophosphamide chemotherapy, were examined using DCE-MRI before neoadjuvant chemotherapy and after two cycles of treatment. Changes in DCE-MRI kinetic parameters (, , , MaxGd, rBV, rBF, MTT) were correlated with the final clinical and pathologic response to neoadjuvant chemotherapy. Test-retest variability was used to determine individual patient response. Twenty-eight patients were evaluable for response (19 clinical responders and 9 nonresponders; 11 pathologic responders and 17 nonresponders). Changes in the DCE-MRI kinetic parameters , , MaxGd, rBV, and rBF were significantly correlated with both final clinical and pathologic response ( < 0.01). Change in was the best predictor of pathologic nonresponse (area under the receiver operating characteristic curve, 0.93; sensitivity, 94\%; specificity, 82\%), correctly identifying 94\% of nonresponders and 73\% of responders. Change in MRI-derived tumor size did not predict for pathologic response. Changes in breast tumor microvessel functionality as depicted by DCE-MRI early on after starting anthracycline-based neoadjuvant chemotherapy can predict final clinical and pathologic response. The ability to identify nonresponders early may allow the selection of patients who may benefit from a therapy change.}, author = {Ah-See, Mei-Lin W. and Makris, Andreas and Taylor, N. Jane and Harrison, Mark and Richman, Paul I. and Burcombe, Russell J. and Stirling, James J. and d'Arcy, James A. and Collins, David J. and Pittam, Michael R. and Ravichandran, Duraisamy and Padhani, Anwar R.}, citeulike-article-id = {3757285}, citeulike-linkout-0 = {http://dx.doi.org/10.1158/1078-0432.CCR-07-4310}, citeulike-linkout-1 = {http://clincancerres.aacrjournals.org/content/14/20/6580.abstract}, citeulike-linkout-2 = {http://clincancerres.aacrjournals.org/content/14/20/6580.full.pdf}, citeulike-linkout-3 = {http://clincancerres.aacrjournals.org/cgi/content/abstract/14/20/6580}, citeulike-linkout-4 = {http://view.ncbi.nlm.nih.gov/pubmed/18927299}, citeulike-linkout-5 = {http://www.hubmed.org/display.cgi?uids=18927299}, day = {15}, doi = {10.1158/1078-0432.CCR-07-4310}, journal = {Clinical Cancer Research}, keywords = {breast, mri, perfusion, response}, month = {October}, number = {20}, pages = {6580--6589}, posted-at = {2009-11-08 08:23:23}, priority = {2}, title = {Early Changes in Functional Dynamic Magnetic Resonance Imaging Predict for Pathologic Response to Neoadjuvant Chemotherapy in Primary Breast Cancer}, url = {http://dx.doi.org/10.1158/1078-0432.CCR-07-4310}, volume = {14}, year = {2008} }

TY - JOUR ID - citeulike:3757285 L3 - citeulike-article-id:3757285 N2 - 10.1158/1078-0432.CCR-07-4310 Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) allows noninvasive, measurements of tissue microvessel perfusion and permeability. We examined whether DCE-MRI done after two cycles of neoadjuvant chemotherapy could predict final clinical and pathologic response in primary breast cancers. Thirty-seven patients with primary breast cancer, due to receive six cycles of neoadjuvant 5-fluorouracil, epirubicin and cyclophosphamide chemotherapy, were examined using DCE-MRI before neoadjuvant chemotherapy and after two cycles of treatment. Changes in DCE-MRI kinetic parameters (, , , MaxGd, rBV, rBF, MTT) were correlated with the final clinical and pathologic response to neoadjuvant chemotherapy. Test-retest variability was used to determine individual patient response. Twenty-eight patients were evaluable for response (19 clinical responders and 9 nonresponders; 11 pathologic responders and 17 nonresponders). Changes in the DCE-MRI kinetic parameters , , MaxGd, rBV, and rBF were significantly correlated with both final clinical and pathologic response ( < 0.01). Change in was the best predictor of pathologic nonresponse (area under the receiver operating characteristic curve, 0.93; sensitivity, 94%; specificity, 82%), correctly identifying 94% of nonresponders and 73% of responders. Change in MRI-derived tumor size did not predict for pathologic response. Changes in breast tumor microvessel functionality as depicted by DCE-MRI early on after starting anthracycline-based neoadjuvant chemotherapy can predict final clinical and pathologic response. The ability to identify nonresponders early may allow the selection of patients who may benefit from a therapy change. IS - 20 JF - Clinical Cancer Research EP - 6589 TI - Early Changes in Functional Dynamic Magnetic Resonance Imaging Predict for Pathologic Response to Neoadjuvant Chemotherapy in Primary Breast Cancer VL - 14 SP - 6580 KW - breast KW - mri KW - perfusion KW - response AU - Ah-See, Mei-Lin AU - Makris, Andreas AU - Taylor, Jane AU - Harrison, Mark AU - Richman, Paul AU - Burcombe, Russell AU - Stirling, James AU - d'Arcy, James AU - Collins, David AU - Pittam, Michael AU - Ravichandran, Duraisamy AU - Padhani, Anwar PY - 2008/10/15/ UR - http://dx.doi.org/10.1158/1078-0432.CCR-07-4310 ER -