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

Abstract

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.

Role of Magnetic Resonance Imaging in Detection of Pathologic Complete Remission in Breast Cancer Patients Treated With Neoadjuvant Chemotherapy: A Meta-analysis

“…A total of 54 studies with 5272 CE-MRI data cases 11,12,[19][20][21] and 8 studies with 539 DW-MRI data cases, 10,51,53,63,64,[76][77][78] were eligible for inclusion in the present meta-analysis. The studies that analyzed the accuracy of MRI had enrolled patients from 1990 to 2013 and had included a median of 95 patients (range, 21-746).…”

“…pCR was defined as the complete disappearance of invasive carcinoma and ductal carcinoma in situ (DCIS) in 23 studies. 12,21,[28][29][30][31][33][34][35]40,41,43,[46][47][48]59,63,65,66,68,70,73,78 In 3 studies, 32,42,76 the definition of pCR was not reported. In 29 studies, 10,11,19,20,[36][37][38][39]44,45,[50][51][52][53][54][56][57][58][60][61][62]64,67,69,71,…”

Comparative Study of Imaging and Histology of Sacroiliac Joint in Normal Rats Based on IVIM-DWI and DCE-MRI

“…The technique also provides Semi-quantitative DCE-MRI using a generalized kinetic model allows for estimation of tissue perfusion and capillary permeability, which involves not only exchange dynamics between extra-vascular/extra-cellular space, but also some other factors, such as the pattern of blood delivery, blood vessel density, vascular permeability, and distribution of contrast agent in lesions [17]. Numerous studies have demonstrated the e ciency of IVIM-DWI and DCE-MRI parameters in prostate cancer [18], breast cancer [19], and liver brosis [20]. However, very few studies have been reported on SIJ.…”

Modern therapies and iatrogenic changes in breast pathology

“…There is a reduction in tumour cellularity in those lesions responding to treatment and this is associated with improved outcome; comparison with pretreatment cellularity forms the basis for several systems for grading response . There are two main radiological patterns: concentric shrinking, where a single tumour mass decreases in size, and the scatter pattern, where there is a patchy response with residual tumour deposits distributed across the tumour bed . These patterns are reflected at the histological level, the latter appearing as scattered nests and islands of tumour cells within a tumour bed composed of reactive fibrous stroma.…”