Early prediction of response to neoadjuvant chemotherapy in patients with breast cancer using diffusion-weighted imaging and gray-scale ultrasonography

Abstract

Neoadjuvant chemotherapy (NACT) is a widely accepted therapeutic option for patients with breast cancer. Although NACT produces good results for breast cancer patients, it has the potential to delay effective treatment in patients with chemotherapy-resistant breast cancer. The purpose of the present study was to evaluate the utility of the pretreatment apparent diffusion coefficient (ADC), which is calculated from diffusion-weighted imaging (DWI), the change in ADC after first administration of NACT, and the change in tumor greatest diameter on ultrasonography in the early prediction of the tumor response to NACT. The response rate of breast tumors to NACT was calculated by the greatest diameter measured by contrast-enhanced MRI obtained before and after NACT. Only the change in ADC was significantly correlated with the response rate. The area under the curve of the change in ADC was sufficiently high (0.90, 95% confidence interval, 0.760–1.040) to discriminate between responders and non-responders. Calculation of the ADC from DWI-MRI was found to be useful for predicting breast tumor response to NACT. Further studies are required to investigate the benefit of changing systemic therapy for breast cancer based on the prediction of the response to NACT by DWI-MRI.

Progress in the clinical detection of heterogeneity in breast cancer

“…This result is consistent with other studies . CEUS also achieved high accuracy in predicting the heterogeneity of the response of breast cancer to neoadjuvant chemotherapy . The use of microbubbles labeled by specific antibodies also allows CEUS to achieve the level of detail of molecular imaging.…”

Apparent diffusion coefficient: Potential biomarker for complete response after neo‐adjuvant chemotherapy in breast cancer

“…According to other studies in literature, [6][7][8][9] we demonstrate that the ΔADC% after four cycles of chemotherapy comparing to the Our results support that DWI sequences should be integrated in the breast MRI protocols. The ΔADC% min may predict pCR within 12 weeks of NAC.…”

“…According to other studies in literature, we demonstrate that the ΔADC% after four cycles of chemotherapy comparing to the basal MRI was significantly higher in pCR neoplasms. We evaluated, for the first time with this purpose, the performance of the minimum ADC value that theoretically represents the area with the highest tumor cellularity, and which, according to our results, could be the best approach to early predict complete response.…”

Targeting PI3K/mTOR Signaling Displays Potent Antitumor Efficacy against Nonfunctioning Pituitary Adenomas

“…Importantly, changes in ADC values following drug treatment preceded significant changes in pituitary tumor volume, as measured by anatomical MRI. Recent studies performed in other tumor entities, including gastrointestinal stromal tumors, hepatocellular carcinomas, and breast cancer, propose DW-MRI as a surrogate marker of response to chemotherapy (42)(43)(44). As shown in a xenograft model of prostate cancer, changes in water molecule diffusion and ADC values can be detected already 24 hours after photodynamic therapy (45).…”