PHOTON MIGRATION OF LOCALLY ADVANCED BREAST CANCER IMPACT OF NEOADJUVANT THERAP

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。新辅助化疗可以实现肿瘤的降期，并在一些患者中允许保乳。对化疗的反应是通过临床评估的。虽然这已被证明与改善无病生存率有关，但尚不清楚对原发肿瘤的临床评估是否准确地反映了病理反应。加州大学旧金山分校乳房中心(N.Hylton和L.Esserman)正在使用MRI来评估新辅助化疗对肿瘤大小和分布的影响。初步结果表明，MRI测量的肿瘤改变优于临床检查，是有意义的生存预测指标。MRI信号来源与肿瘤部位血容量分数、血流灌注量和空间范围的变化有关。这些正是手持式FDPM光学探头在单次非侵入性测量中可以提供的功能参数。因此，我们将启动一项先导性研究，检查10名加州大学旧金山分校的患者。每个患者都将在加州大学旧金山分校接受基线MRI扫描，然后在UCI接受光学扫描。随后的MRI扫描将在每个化疗周期(AC、阿霉素/环磷酰胺)之后进行。为了最大限度地减少前往欧文的次数，第二次也是最后一次光学扫描将在第四个交流周期之后完成，恰好在手术前完成。由于光学和核磁共振提供了互补的功能信息，我们相信这些结果将为这些疗法的机制提供有价值的见解，并有助于建立预测药物疗效的实用标准。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Neoadjuvant chemotherapy can achieve tumor downstaging and allow breast conservation in some patients. Response to chemotherapy is assessed clinically. Although this has been shown to be associated with improved disease-free survival, it is not clear whether clinical assessment of the primary tumor accurately reflects pathologic response. The UCSF Breast Center (N. Hylton and L. Esserman) are using MRI to assess changes in tumor size and distribution in response to neoadjuvant chemotherapy. Preliminary results indicate that tumor changes measured by MRI are better than clinical exam and are meaningful predictors of survival. The MRI signal origin is related to changes in blood volume fraction, perfusion, and spatial extent of the tumor site. These are precisely the functional parameters that the hand-held FDPM optical probe can provide in a single, non-invasive measurement. As a result, we will initiate a pilot study that examines 10 UCSF patients. Each patient will receive baseline MRI scans at UCSF, followed by optical scans at UCI. Subsequent MRI scans will be performed following each cycle of chemotherapy (AC, Adriamycin/Cyclophosphamide). In order to minimize the number of trips to Irvine, a second and final optical scan will be completed following the 4th AC cycle, just prior to surgery. Because optical and MRI provide complementary functional information, we believe these results will provide valuable insight into the mechanisms these therapies as well as help establish practical criteria for predicting drug efficacy