Dynamic enhanced MRI predicts chemosensitivity in breast cancer patients
Dynamic enhanced MRI predicts chemosensitivity in breast cancer patients
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DOI：
10.1016/j.ejrad.2006.07.014
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发表时间：
2006-11-01
影响因子：
3.3
通讯作者：
Miyazaki, Masaru
中科院分区：
文献类型：
--
作者：
Nagashima, Takeshi;Sakakibara, Masahiro;Miyazaki, Masaru
背景：乳腺癌的初次化疗作为术后辅助治疗是有效的。然而，一个关键的缺点是进展性疾病患者的治疗延迟。本研究试图阐明MRI上可用于预测乳腺癌患者对治疗敏感性的量化参数。方法：研究对象为26例术前接受初次化疗的浸润性导管癌患者。肿瘤平均最大径为3.3 cm，21例有结节侵犯。3例组织学分级为3级。动态增强MRI在三个不同的时间段进行评估：术前、术前化疗中和首次手术前。计算信号强度比(SIR)和早期对比摄取(ECU)，并分析其与肿瘤缩小率的相关性。结果：化疗有效组的SIR和ECU值显著高于无效组(P分别为0.0454和0.0334)。化疗后肿瘤缩小，ECU值明显降低(p=0.0028)。病理肿瘤大小与术前磁共振成像估计的肿瘤大小显著相关(p<；0.0001)。结论：我们的系列研究显示乳腺癌患者术前磁共振成像数据与化疗后肿瘤缩小显著相关。有了这些结果，似乎有可能在治疗前确定好的和无反应的。(C)2006爱思唯尔爱尔兰有限公司。保留所有权利。
Background: Primary chemotherapy for breast cancer is effective as postoperative adjuvant therapy. However, one of the critical disadvantages was a treatment delay for patients with progressive disease. The present study attempts to clarify quantitative parameters on MRI which can be used to predict the sensitivity to treatment in breast cancer patients.Methods: The subjects consisted of 26 patients with invasive ductal breast cancer who received primary chemotherapy before surgery. The mean maximum tumor dimension was 3.3 cm, and 21 cases had nodal involvements. Three cases demonstrated histological grade 3. Dynamic enhanced MRI was evaluated at three different time periods; prior to, in the midst of preoperative chemotherapy, and just before the initial operation. The signal intensity ratio (SIR) and early contrast uptake (ECU) were calculated, as well as the correlation between these dynamic data and the tumor reduction rates were analyzed retrospectively. P-values of less than 0.05 were considered to indicate statistically significant.Results: Responders to chemotherapy had the significantly higher SIR and ECU values than non-responders (p = 0.0454 and 0.0334, respectively). ECU value significantly decreased as tumor reduction by chemotherapy (p = 0.0028). Pathological tumor dimension was significantly correlated with the tumor size estimated on presurgical MRI (p < 0.0001).Conclusions: Our current series demonstrated the significant correlation between pretreatment MRI data and tumor reduction by chemotherapy in breast cancer patients. With these results, it seems possible to define good and non-responders prior to treatment. (C) 2006 Elsevier Ireland Ltd. All rights reserved.