DW-MRI ADC values can predict treatment response in patients with locally advanced breast cancer undergoing neoadjuvant chemotherapy
DW-MRI ADC values can predict treatment response in patients with locally advanced breast cancer undergoing neoadjuvant chemotherapy
复制标题
DOI：
10.1007/s12032-011-9842-y
复制
发表时间：
2012-06-01
期刊：
影响因子：
3.4
通讯作者：
Liu, Lei
中科院分区：
文献类型：
--
作者：
Li, Xi-ru;Cheng, Liu-quan;Liu, Lei
本研究的目的是评价扩散加权磁共振成像（DW-MRI）表观扩散系数（ADC）值预测局部晚期乳腺癌（LABC）患者对新辅助化疗（NCT）的治疗反应的重要性。32例LABC患者接受了2-4个周期的NCT（多西他赛和表阿霉素）。分别于化疗前1周内和第1疗程后进行DW-MRI扫描。相应地，分析肿瘤体积、肿瘤ADC值的变化及其相关程度。2个周期NCT治疗后，62.5%（95% CI，45.7-79.3%）的患者观察到总体缓解（OR）。临床完全缓解率（CR）为15.6%，病理完全缓解率（pCR）为9.4%。疾病稳定（SD）率为34.4%（11例患者），仅1例患者（3.1%）观察到疾病进展（PD）。第1周期NCT后，CR + PR组ADC值明显升高（P < 0.001）。OR组化疗前初始ADC值明显低于SD + PD组（P < 0.001）。初始ADC值与化疗后肿瘤体积变化呈负相关（r =-0.58，P = 0.02）。肿瘤初始ADC值越低，化疗后肿瘤体积缩小越明显。化疗后肿瘤ADC值的变化与肿瘤体积的变化呈正相关（r = 0.96，P < 0.001）。化疗后，ADC值变化越大，肿瘤体积缩小越多。使用乳腺癌肿瘤的初始ADC值和NCT后ADC值的早期变化，我们可能能够预测肿瘤对化疗的反应。初始ADC值较低的肿瘤可能对化疗敏感;化疗后早期ADC值显著增加的肿瘤可能对化疗敏感。
The purpose of this study was to evaluate the importance of diffusion-weighted magnetic resonance imaging (DW-MRI) apparent diffusion coefficient (ADC) values to predict treatment response to neoadjuvant chemotherapy (NCT) in patients with locally advanced breast cancer (LABC). Thirty-two patients with LABC underwent 2-4 cylces of NCT (docetaxel and epirubicin). The DW-MRI scans were performed within one week prior to chemotherapy and after the first course of treatment, respectively. Accordingly, tumor volumes, changes in tumor ADC values, and their degree of correlation were analyzed. The overall response (OR) was observed in 62.5% (95% CI, 45.7-79.3%) of patients after 2 cycles of NCT. The clinical complete response (CR) rate and pathological CR (pCR) rate were 15.6 and 9.4%, respectively. The stable disease (SD) rate was 34.4% (11 patients), and progressive disease (PD) was observed in only one patient (3.1%). After the first cycle of NCT, the ADC values in the CR + PR group significantly increased (P < 0.001). The initial ADC values before chemotherapy in the OR group were significantly lower than those in the SD + PD group (P < 0.001). The initial ADC values and the changes in tumor volume after chemotherapy were negatively correlated (r = -0.58, P = 0.02). The lower the initial tumor ADC value was the more obvious the decrease in tumor volume after chemotherapy. The changes in ADC values of tumors after chemotherapy and the changes in tumor volume were positively correlated (r = 0.96, P < 0.001). After chemotherapy, the greater the change in ADC value, the more the tumor volume was reduced. Using the initial ADC values of breast cancer tumors and the early changes in ADC values after NCT, we may be able to predict tumor response to chemotherapy. Tumors with low initial ADC values may be sensitive to chemotherapy; tumors with significantly increasing ADC values early after chemotherapy may be sensitive to chemotherapy.