PHOTON MIGRATION OF LOCALLY ADVANCED BREAST CANCER IMPACT OF NEOADJUVANT THERAP

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。新辅助化疗可以实现肿瘤的降级，并允许在一些患者中保留乳房。临床评估对化疗的反应。虽然这已被证明与改善无病生存期相关，但尚不清楚原发性肿瘤的临床评估是否准确反映了病理学反应。UCSF乳腺中心（N。Hylton和L. Esserman）正在使用MRI评估肿瘤大小和分布对新辅助化疗的反应。初步结果表明，通过MRI测量的肿瘤变化优于临床检查，并且是有意义的生存预测因子。MRI信号来源与肿瘤部位的血液体积分数、灌注和空间范围的变化有关。这些正是手持式FDPM光学探头可以在单次非侵入式测量中提供的功能参数。因此，我们将启动一项试点研究，检查10名UCSF患者。 每位患者将在UCSF接受基线MRI扫描，然后在UCI接受光学扫描。在每个化疗周期（AC、阿霉素/环磷酰胺）后进行后续MRI扫描。为了尽量减少前往Irvine的次数，将在第4次AC循环后（手术前）完成第二次和最后一次光学扫描。由于光学和MRI提供了互补的功能信息，我们相信这些结果将为这些治疗机制提供有价值的见解，并帮助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