Changes in the findings of dynamic MRI by preoperative CAF chemotherapy for patients with breast cancer of stage II and III: pathologic correlation.

Tsuboi, Narumi; Ogawa, Yasuhiro; Inomata, Taisuke; Yoshida, Dai; Shoji, Yasuhiro; Moriki, Toshiaki; Kumon, Masamitsu

doi:10.3892/or.6.4.727

Cited by 30 publications

(29 citation statements)

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“…cE-breast mri obtains over 95% sensitivity in the detection of breast cancer through enhancement of the lesion with gadolinium-based contrast material (29,30), and accurately reveals the tumor extent regardless of prior neoadjuvant chemotherapy (31)(32)(33). uS has been reported to be more reliable for the detection and measurement of breast tumors than mammography, particularly in case of dense breast tissue (34)(35)(36).…”

Section: Discussionmentioning

confidence: 99%

Non-surgical therapy and radiologic assessment of stage I breast cancer treatment with novel enzyme-targeting radiosensitization: Kochi Oxydol-Radiation Therapy for Unresectable Carcinomas, type II (KORTUC II)

Hitomi

Kubota

Ogawa

et al. 2010

Experimental and Therapeutic Medicine

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Abstract. the new enzyme-targeting radiosensitization treatment, kochi Oxydol-radiation therapy for unresectable carcinomas, type ii (kOrtuc ii), markedly enhances the radiotherapeutic effect of treatment for various types of locally advanced malignant neoplasms. patients who had declined surgical treatment and systemic chemotherapy, as well as a total of 14 stage i breast cancer patients, were enrolled. a maximum of 6 ml of kOrtuc ii was injected into tumor tissue twice a week under ultrasonographic guidance, immediately prior to each administration of radiation therapy. the median observation period was 21.6 months with a range of 4-48 months, and the therapy was well tolerated. contrast-enhanced magnetic resonance imaging and [18 F]-fluorodeoxyglucose positron emission computed tomography revealed that all primary breast tumors completely responded, and none of the subjects experienced local recurrence during the observation period. ultrasonography depicted tumor-like findings in 2/14 cases after therapy. The intratumoral flow signal on color-Doppler sonography was positive in 4/14 cases before therapy, and the signal disappeared from all cases after therapy. The absence of a flow signal after therapy suggested that the tumor-like findings on ultrasonography were from scar tissue. Excellent local control based on accurate radiological evaluation implies that kOrtuc ii has the potential to replace surgery as a therapeutic option for stage i breast cancer. precise evaluation by various radiological modalities helped to gage the success of this therapy. IntroductionBreast conserving surgery has become the most popular surgical procedure for primary breast cancer (1). The significance of extended resection has become less important, since the long-term survival rate among women who undergo breastconserving surgery is the same as that among women who undergo radical mastectomy (2). thus, nowadays, local control is expected to be minimally invasive on the basis that permanent curability is estimated to be comparable. Various types of non-surgical ablation have been introduced as a local control for early breast cancer that also achieve cosmetic gains (3-7). a new enzyme-targeting radiosensitization treatment containing hydrogen peroxide and sodium hyaluronate for percutaneous injection, kochi Oxydol-radiation therapy for unresectable carcinomas, type ii (kOrtuc ii) (8), was recently developed. it markedly enhances the radiotherapeutic effect of treatment for various types of tumors that are not superficially exposed, such as breast cancer and other types of soft tissue tumors (8). As precise assessment of therapeutic efficacy by radiological imaging is essential for the success of kOrtuc ii, contrast enhanced breast magnetic resonance imaging (cE-breast mri), ultrasonography (uS) and [18 F]-fluorodeoxyglucose positron emission computed tomography (FdG-pEt-ct) were employed to assess therapeutic outcomes. the aim of the present study was to report the therapeutic outcome of kOrtuc ii for stage i breast cancer precis...

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Section: Discussionmentioning

confidence: 99%

Non-surgical therapy and radiologic assessment of stage I breast cancer treatment with novel enzyme-targeting radiosensitization: Kochi Oxydol-Radiation Therapy for Unresectable Carcinomas, type II (KORTUC II)

Hitomi

Kubota

Ogawa

et al. 2010

Experimental and Therapeutic Medicine

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“…Among conventional modalities such as ultrasonography, mammography and computed tomography (1-3), magnetic resonance imaging (MRI) has priority for the detection of breast cancer and for the evaluation of breast cancer response to neoadjuvant chemotherapy (NAC) (4)(5)(6)(7)(8)(9)(10)(11). Enhancement curves by dynamic MRI (DMRI) are known to be useful for detecting or monitoring breast cancer (4,12,13).…”

Section: Introductionmentioning

confidence: 99%

Choline by magnetic spectroscopy and dynamic contrast enhancement curve by magnetic resonance imaging in neoadjuvant chemotherapy for invasive breast cancer

Murata¹

2008

Mol Med Rep

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Abstract. This study investigated the relationship between choline by magnetic resonance spectroscopy (MRS) and late enhancement curves by dynamic magnetic resonance imaging (DMRI) in determining therapeutic response to neoadjuvant chemotherapy (NAC) among invasive breast cancer patients. Subjects comprised 21 women (22 breasts) with biopsyconfirmed invasive breast cancer (mean age 54 years) who underwent MRS with choline and gadolinium-enhanced DMRI at 1.5 T before and after NAC. Choline signals on MRS were classified into 2 patterns: choline-positive or cholinenegative, while late enhancement curves were classified as 'plateau' or 'washout' (type A), or 'persistent' (type B) according to the consensus of 2 radiologists. Maximum tumor diameters and clinical tumor reduction rates were assessed by MRI. Before NAC, choline-positive results were found in all 22 tumors, 21 of which were type A and 1 of which was type B. After NAC, a change from choline-positive to cholinenegative was observed with MRS in 11 tumors, while another 11 remained choline-positive. According to DMRI, enhancement curves changed from type A to type B in 14 tumors, remained type A in 7 tumors, and remained type B in 1 tumor. Tumor reduction rates were significantly greater for cholinenegative tumors than for choline-positive tumors after NAC (p=0.0115). Following NAC, no significant correlation was noted between enhancement curves and reduction rates (p=0.1210), although a significant correlation was noted between enhancement curves and choline signals (p=0.0014). Changes in choline signals as noted using MRS might offer advantages over changes in enhancement curves by DMRI when evaluating response to NAC in terms of the tumor reduction rate in invasive breast cancer. IntroductionAmong conventional modalities such as ultrasonography, mammography and computed tomography (1-3), magnetic resonance imaging (MRI) has priority for the detection of breast cancer and for the evaluation of breast cancer response to neoadjuvant chemotherapy (NAC) (4-11). Enhancement curves by dynamic MRI (DMRI) are known to be useful for detecting or monitoring breast cancer (4,12,13). In addition to MRI, magnetic resonance spectroscopy (MRS) is becoming increasingly attractive for the detection or monitoring of breast cancer (14-24). MRS detects elevated levels of cholinecontaining compounds in breast cancer tissue, which yield a signal at a chemical shift of 3.2 ppm (25). Choline by MRS and enhancement curves by DMRI represent common methods for dealing with non-morphological diagnostic parameters. The present study therefore assessed the correlation between MRS and enhancement curves from DMRI in determining response to NAC. Materials and methodsPatients. The present study was performed at our institution between January 2007 and Feburary 2008. Subjects comprised 21 patients with invasive ductal breast carcinoma (unilateral n=20; bilateral n=1) diagnosed by ultrasonography-guided fine needle biopsy. Mean subject age was 54 years (range 40-67 years).Neoadjuvant chemo...

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“…Second, we used the bi-axial diameter product as tumor size, although the threedimensional product from tumor morphology would also be acceptable. Third, only two b-factors of 0 and 1,500 s/mm 2 were used. The use of multiple b-values, including those higher and lower than 1,500, would have enabled a more detailed discussion to be added to our results.…”

Section: Discussionmentioning

confidence: 99%

“…Among the various tools for monitoring the response to NAC for breast cancer, contrast-enhanced magnetic resonance imaging (MRI) is considered to be superior to any other imaging modality due to its high spatial resolution (1)(2)(3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Diffusion-weighted magnetic resonance imaging for assessment after neoadjuvant chemotherapy in breast cancer, based on morphological concepts

Murata

Kubota²,

Hamada³

et al. 2010

Oncology Letters

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Abstract. The study aimed to evaluate the utility of diffusionweighted imaging (DWI) and to assess the response of breast cancer patients to neoadjuvant chemotherapy (NAC), based on morphological concepts. This retrospective study included 35 breast cancer patients (36 lesions) who had conventional magnetic resonance imaging (MRI), with DWI acquired before and after NAC. The morphological pattern of delayed enhancement on MRI before NAC was classified into two types: focal mass (FM), and multiple masses and/or non-mass like (MM/NM), based on Breast Imaging Reporting and Data System (BI-RADS). Of the 36 tumors, 26 were classified as FM and 10 as MM/NM. Tumors were clearly visualized on the initial DWI although one case of suspected MM/NM was not observed on DWI following NAC. A correlation was found between changes in the apparent diffusion coefficient and response rates to NAC in FM tumors (r=0.608, p<0.001), but not in MM/NM tumors (r=0.141, p=0.717). There was agreement between MRI findings after NAC and pathological findings in 30 of the 36 tumors (83.3%). Thus, we concluded that DWI is potentially useful in assessing the response to NAC for breast cancer for tumors diagnosed as FM on the initial conventional MRI.

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Changes in the findings of dynamic MRI by preoperative CAF chemotherapy for patients with breast cancer of stage II and III: pathologic correlation.

Cited by 30 publications

References 0 publications

Non-surgical therapy and radiologic assessment of stage I breast cancer treatment with novel enzyme-targeting radiosensitization: Kochi Oxydol-Radiation Therapy for Unresectable Carcinomas, type II (KORTUC II)

Non-surgical therapy and radiologic assessment of stage I breast cancer treatment with novel enzyme-targeting radiosensitization: Kochi Oxydol-Radiation Therapy for Unresectable Carcinomas, type II (KORTUC II)

Choline by magnetic spectroscopy and dynamic contrast enhancement curve by magnetic resonance imaging in neoadjuvant chemotherapy for invasive breast cancer

Diffusion-weighted magnetic resonance imaging for assessment after neoadjuvant chemotherapy in breast cancer, based on morphological concepts

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