Objective To assess the clinical efficacy of neoadjuvant chemotherapy (NAC) for breast invasive ductal carcinoma with MR diffusion weighted imaging.
Methods Thirty patients with breast invasive ductal carcinoma underwent conventional MRI scanning and diffusion weighted imaging examination before and after preoperative neoadj-uvant chemotherapy. Two experienced radiologists independently analyzed and measured the maximum lesion diameter and apparent diffusion coefficient (ADC) values before and after treatment,respectively. Statistical analysis was performed for testing the tumor maximum diameter and ADC values change by using the paired t-test.
Results After NAC treatment,the maximum tumor diameter of invasive ductal breast carcinoma sharply reduced〔(4.33±0.83) cm vs. (2.04±0.64) cm,P<0.001〕. When b value was 1 000,the mean ADC values of breast massess were significantly changed after NAC treatment〔(1.89±0.15) ×10-3mm2/s vs. (1.14±0.31) ×10-3mm2/s, P<0.05〕.
Conclusion MR diffusion weighted imaging can non-invasively and accurately assess the NAC efficacy, which are helpful for making surgical strategies.
Citation:
ZHANG Lizhi,ZENG Hanjiang,HUANG Zixing,YU Jianqun.. Assessing The Neoadjuvant Chemotherapy Efficacy for Breast Invasive Ductal Carcinoma with MR Diffusion Weighted Imaging. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(1): 88-91. doi:
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刘春萍, 潘华雄, 杨帆, 等. MRI 在乳腺癌新辅助化疗后行保乳手术中的应用[J]. 华中科技大学学报(医学版), 2009, 8(3):374-376.
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金光韦, 蔡幼铨, 安宁豫, 等. 磁共振成像在乳腺癌新辅助化疗疗效评估中的应用[J]. 军事医学, 2012, 36(1):289-293.
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- 1. Roben SM, Leach MO. Imaging biochemistry:applications to breast cancer[J]. Breast Cancer Res, 2001, 3(1):36-40.
- 2. Hylton N. MR imaging for assessment of breast cancer response to neoadjuvant chemotherapy[J]. Magn Reson Imaging Clin N Am, 2006, 14(3):383-389.
- 3. Smith IC, Hey SD, Hutcheon AW, et al. Neoadjuvant chemotherapy in breast cancer:significantly enhanced response with docetaxel[J]. J Clin Oncol, 2002, 20(6):1456-1466.
- 4. Rouzier R, Mathieu MC, Sideris L, et al. Breast-con serving surgery after neoadjuvant anthracycline-based chemotherapy for large breast tumors[J]. Cancer, 2004, 101(5):918-925.
- 5. Junkermann H, von Fournier D. Imaging methods for evaluating the response of breast carcinoma to preoperative chemotherapy[J]. Radiology, 1997, 37(9):726-732.
- 6. Pickles MD, Gibbs P, Lowry M, et al. Diffusion changes precede size reduction in neoadjuvant treatment of breast cancer[J]. Magn Reson Imaging, 2006, 24(7):843-847.
- 7. 赵斌, 蔡世峰, 高佩虹, 等. MR 扩散加权成像鉴别乳腺良恶性病变的研究[J]. 中华放射学杂志, 2005, 39(5): 497-500.
- 8. 刘溢, 谢敬霞, 韩鸿宾, 等. 磁共振扩散加权成像在乳腺肿瘤的初步应用[J] . 中国医学影像技术, 2003, 19(5): 548-551.
- 9. 郭勇, 蔡祖龙, 蔡幼铨, 等. 弥散加权成像鉴别乳腺良恶性病变的价值初探[J] . 中华放射学杂志, 2001, 35(2): 132-135.
- 10. 杨丽, 时高峰, 刘辉, 等. 磁共振扩散加权成像及表观扩散系数值测量在乳腺良恶性病变鉴别诊断中的价值[J]. 临床荟萃, 2011, 26(12): 1082-1085.
- 11. Sinha S, Lucas-Quesada FA, Sinha U, et al. In vivo diffusion-weighted MRI of the breast:potential for lesion characterization[J] . J Magn Reson Imaging, 2002, 15(6):693-704.
- 12. 于韬, 罗娅红, 邱岩, 等. DWI 结合时间-信号强度曲线评价乳腺病变性质的研究[J]. 现代肿瘤医学, 2009, 17(8):1461-1464.
- 13. 白伟, 陈自谦, 叶友强, 等. 磁共振扩散加权成像在乳腺良恶性病变中的诊断价值[J] . 临床军医杂志, 2011, 39(2):272-274.
- 14. 徐成. MRI 在乳腺癌新辅助化疗疗效评价中的应用研究[J]. 实用医学影像杂志, 2010, 11(3): 198-201.
- 15. 谢洁林, 汪登斌, 陈克敏, 等. 乳腺磁共振扩散成像表观弥散系数值差异的比较研究[J]. 外科理论与实践, 2008, 13(11):126-129.
- 16. Rajan R, Poniecka A, Smith T L, et al. Change in tumor cellula-rity of breast carcinoma after neoadjuvant chemotherapy as a vari-able in the pathologic assessment of response[J]. Cancer, 2004,100(7):1365-1373.
- 17. Padhani AR. Functional MRI for anticancer therapy assessment[J]. Eur J Cancer, 2002, 38(16): 2116-2127.
- 18. 金光韦, 蔡幼铨, 安宁豫, 等. 表观扩散系数预测乳腺癌新辅助化疗反应初探[J]. 中华放射学杂志, 2008, 42(3):289-293.
- 19. Lee KC, Moffat BA, Schott AF, et al. Prospective early responseimaging biomarker for neoadjuvant breast cancer chemotherapy[J]. Clin Cancer Res, 2007, 13(2 Pt 1):443-450.
- 20. Guo Y, Cai YQ, Cai ZL, et al. Differentiation of clinically benignand malignant breast lesions using diffusion-weighted imaging[J]. J Magn Reson Imaging, 2002, 161(2):172-178.
- 21. Sharma U, Danishad KK, Seemu V, et al. Longitudinal study of the assessment by MRI an d diffusion-weighted imaging of tumorresponse in patients with locally advanced breast cancer undergoingneoadjuvant chemotherapy[J]. NMR Biomed, 2009, 22(1):104-113.
- 22. 刘春萍, 潘华雄, 杨帆, 等. MRI 在乳腺癌新辅助化疗后行保乳手术中的应用[J]. 华中科技大学学报(医学版), 2009, 8(3):374-376.
- 23. 刘荫华, 刘倩. 客观解读RECIST (修订版) 的临床评价意义[J]. 中国实用外科杂志, 2010, 30 (1):31-33.
- 24. 金光韦, 蔡幼铨, 安宁豫, 等. 磁共振成像在乳腺癌新辅助化疗疗效评估中的应用[J]. 军事医学, 2012, 36(1):289-293.