PURPOSE: The aim of this study was to evaluate whether quantitative changes in contrast enhancement (CE) after neoadjuvant chemotherapy (NC) are associated with histological signs of tumor regression and whether quantitative dynamic MRI (dMRI) is capable of accurately assessing preoperative tumor size compared to mammography (MG) and ultrasound (US). METHODS: Thirty-one patients with breast cancer underwent MRI before and after NC. Dynamic CE was measured using a turbo-FLASH sequence and quantified by a two-compartment model, where two parameters, k(ep) (distribution constant rate) and A (amplitude), were calculated and color mapped. RESULTS: When tumors had signs of histological regression in the operative specimen (n=17) decrease of the parameters A and k(ep) was significantly more marked compared to tumors without regression (n=12). The correlation between tumor size measured by dMRI and histopathology was 0.81 when areas of unspecific CE were included; when they were not included the correlation was 0.66 and tumor size was systematically underestimated. In 26 patients dMRI was retrospectively compared with MG (r=0.51; dMRI, r=0.80) and in 22 patients with US (r=0.60; dMRI, r=0.75). CONCLUSION: Changes in dynamic CE are associated with histological tumor regression. Quantitative dMRI enables a valid assessment of tumor residue and is superior to MG and US. Remaining unspecific CE within the original tumor site should be considered as potentially malignant.
PURPOSE: The aim of this study was to evaluate whether quantitative changes in contrast enhancement (CE) after neoadjuvant chemotherapy (NC) are associated with histological signs of tumor regression and whether quantitative dynamic MRI (dMRI) is capable of accurately assessing preoperative tumor size compared to mammography (MG) and ultrasound (US). METHODS: Thirty-one patients with breast cancer underwent MRI before and after NC. Dynamic CE was measured using a turbo-FLASH sequence and quantified by a two-compartment model, where two parameters, k(ep) (distribution constant rate) and A (amplitude), were calculated and color mapped. RESULTS: When tumors had signs of histological regression in the operative specimen (n=17) decrease of the parameters A and k(ep) was significantly more marked compared to tumors without regression (n=12). The correlation between tumor size measured by dMRI and histopathology was 0.81 when areas of unspecific CE were included; when they were not included the correlation was 0.66 and tumor size was systematically underestimated. In 26 patientsdMRI was retrospectively compared with MG (r=0.51; dMRI, r=0.80) and in 22 patients with US (r=0.60; dMRI, r=0.75). CONCLUSION: Changes in dynamic CE are associated with histological tumor regression. Quantitative dMRI enables a valid assessment of tumor residue and is superior to MG and US. Remaining unspecific CE within the original tumor site should be considered as potentially malignant.
Authors: M V Knopp; E Weiss; H P Sinn; J Mattern; H Junkermann; J Radeleff; A Magener; G Brix; S Delorme; I Zuna; G van Kaick Journal: J Magn Reson Imaging Date: 1999-09 Impact factor: 4.813
Authors: Savannah C Partridge; Jessica E Gibbs; Ying Lu; Laura J Esserman; Dan Sudilovsky; Nola M Hylton Journal: AJR Am J Roentgenol Date: 2002-11 Impact factor: 3.959
Authors: Laura Martincich; Filippo Montemurro; Giovanni De Rosa; Vincenzo Marra; Riccardo Ponzone; Stefano Cirillo; Marco Gatti; Nicoletta Biglia; Ivana Sarotto; Piero Sismondi; Daniele Regge; Massimo Aglietta Journal: Breast Cancer Res Treat Date: 2004-01 Impact factor: 4.872
Authors: Aida Kuzucan; Jeon-Hor Chen; Shadfar Bahri; Rita S Mehta; Philip M Carpenter; Peter T Fwu; Hon J Yu; David J B Hsiang; Karen T Lane; John A Butler; Stephen A Feig; Min-Ying Su Journal: Clin Breast Cancer Date: 2012-04 Impact factor: 3.225
Authors: Jeon-Hor Chen; Shadfar Bahri; Rita S Mehta; Aida Kuzucan; Hon J Yu; Philip M Carpenter; Stephen A Feig; Muqing Lin; David J B Hsiang; Karen T Lane; John A Butler; Orhan Nalcioglu; Min-Ying Su Journal: Radiology Date: 2011-08-30 Impact factor: 11.105