Mri Study Of Neoadjuvant Chemotherapy In Breast Cancer

Purpose To explore alteration of kinetic characteristics in dynamic enhancement-MRI(DCE-MRI) correlation with pathological response,which provid more ways in assessing the tumor response and prognosis to neoadjuvant chemother-apy in breast cance. Methods 26 patients with surgically and pathologically proven breast carcinoma who had breast DCE-MRI examation before and after NAC. Time——signal intensity curve (TIC) and the semi-quantitative parameters of DCE-MRI were calculated before and after chemotherapy on AW43 workstation. Based on their pathological response (Miller & Payne), patients were assigned to five groups.Results The semi-quantitative parameters had significant alteration before and after NAC, that as followed:The mean value of Efirst, Vfirst, Ee,Ve,Emax,Vmax, Slopemax, Ewash, Vwash after chemotherapy were lower than those value before chemotherapy (P<0. 05), Tmax had significant higher than those value before chemotherapy (P<0.05). In total 26 cases,the type of TIC before chemotherapy were 9 cases (typeⅢ),6 cases (typeⅡ),1case (typeⅠ);however,9 cases (typeⅢ),6 cases (typeⅡ),1 case (typeⅠ) after chemotherapy. The type of curve before chemotherapy changed fromⅢ/ⅡtoⅡ/Ⅰin 22 of 26 cases with residual disease after chemotherapy;3 cases unchanged; 1 case changed fromⅡtoⅢ. On pathological response,MP1 responses were achieved in 3 cases (11.5%);MP2 in 6 csaes (23.1%); MP3 in 6 csaes (23.1%);MP4 in 9 csaes (34.6%);MP5 in 2 cases (7.7%).After chemotherapy,2 of 3 cases typeⅢTIC correlated with MP1, and 1 case correlated with MP2; 2 of 3 cases typeⅢTIC correlated with MP1,and 1 case correlated with MP2; 1 of 7 cases typeⅡTIC correlated with MP1,1 correlated with MP2,4 correlated with MP3,1 correlated with MP4;1 of 16 cases typeⅠTIC correlated with MP2,5 correlated with MP3,8 correlated with MP4,2 correlated with MP5. The type of TIC and pathologicalresponse grades had significant correlation (P=0.04<0.05). Conclusion:The mean value of semi-quantitative parameters had significant alteration in a reduced speed and decreased blood flow before and after NAC. Time signal intensity curve tend to change from typeⅢ/Ⅱto typeⅠ.Pathological response after NAC could be characterized using type of TIC on DEC-MRI. The method may be employed for monitoring response and assessing the prognosis to NAC. Purpose:To investigate whether an adjacent vessel on vascular maps can help differentiate malignant from benign breast lesions and therefore increase the additional sign of breast MRI,and study of alteration in neoadjuvant chemotherapy (NAC). Materials andMethods:In total 80 patients, Dynamic contrast-enhanced (DCE) MRI performed on 64 patients without NAC,26 with DCE-MRI before and after NAC.Vascular maps (Maximum intensity projections,MIPS) were obtained by using second post-injection phase abstract mask.Vascula-rization was scored on the MRI vascular maps.The score ranged from 0 to 3 which according to the methods from Sardanelli et al.Pathological response was assessed according to Miller & Payne five points classification.Results:Final analysis of 64 cases without NAC revealedthe mean number of vessels±SD per breast in the malignant cases was 3.80±2.02, compared with 1.17±1.10 vessels per breast in benign cases (P<0.001).When the breast vascularity score was used in patientswith category 0-1 was benign, and patients with category 2-3 was malignant, the s ensitivity and specificity of breast MRI was 78.6% and 83.3%,respectively.In 26 cases with NAC, the mean number of vessels±SD per breast before NAC was 4.04±1.28,compared with 2.38±1.75 vessels per breast after NAC. Significant difference in number of vessels existed between the pre-and post-NAC (P=0.00<0.05).The mean number of vessels per breast in 23 of 26 responders was 2.17±1.26, compared with 4.0±2.65 vessels in 3 of 26 non-responders to NAC.Therewas no significant difference (P=0.312>0.05).Conclusion:The presence of an adjacent vessel seen on subtraction images promises to be agood marker for malignancy and can therefore help increase additionalsign of breast MRI. breast cancer after NAC was reduced in the numberof vessels,this was potentially useful to advanced study blood vesselsalteration in NAC. potentially useful to monitor the response of angiogenic compositions of a tumour throughout the course of chemotherapy,and might predict tumour response early in the course. Objective To evaluate the role of magnetic resonance imaging (MRI) in assessing the tumor response and the diagnostic performance in residual tumor to neoadjuvan chemotherapy (NAC) in breast cancer.Methods Twenty-six patients (aged 34-70 years) with breast cancer received neodjuvant chemotherapy (NAC) were included. Breast B ultrasonography and dynamic enhanced MRI (DCE-MRI) was performed before and after the NAC prior to the surgery.The maximum diameter of residua 1 disease was examined by MRI and B ultrasonography, comparing to pathological examination. Response evaluation was madeby B ultrasonography and MRI, based on the response evaluation criteria in solid tumors(RECIST). Pathological response was assessed according to Miller & Payne five points classification. Results Among twenty—six patients,twenty-six lesions in 24 cases(double lesions in 2 cases) were found on pathological examination,two lesions dispeared; On MRI and US examination,25 lesions in 23 cases,27 lesions in 23 cases were diagnosed,3 and 1 lesions were negative,repectively; Magnetic resonance imaging had 96.2% sensitivity and 100% specificity for the detection of residual invasive cancer,US had 100% sensitivity and50% specificity.The mean size of residual tumor after chemotherapy on MRI,US and pathology was 3.18±1.32cm,2.78±1.4cm and 2.81±1.308cm, repectively. Magnetic resonance imaging appears to be superior to uson correlated with post—operative pathologic findings (R=0.866).Based on RECIST with enhanced MRI,3 complete responders (CR),19 partial responders (PR) and 4 non-responder were documented, in total 22 reponser.Measured by B ultrasonography,19 patients got PR,6 got SD,0 got PD, 1got CR,in total 20 reponser and 6 non-responder were documented. The agreement between MRI and Patholgy assessment for reponder was 100%,76.7% for no-responder;However, The agreement between US and Patholgy assessment for reponder was 100%,50% for no-responder.Conclusions As compared to pathology specimens,MRI is able to represent the extent of cancer and response after NAC more accurately than US. Purpose:To investigate whether T2 relaxtion time can help differentiate malignant from benign breast lesions and therefore increase the additional sign of breast MRI.,and study of alteration in neoadjuvant chemotherapy(NAC).Materials and methods:In total 67 patients,pathology revealed 47 malignant cases and 21 benign cases,26 cases of the 47 malignant cases undergoing NAC. MRI T2mapping performed on 41 patients without NAC, 26 with MRI T2mapping before and after NAC. T2 relaxtion time were obtained by using funtool softewareon AW 43 workstation.Pathological response wasassessed according to Miller & Payne five points classification.Results:Final analysis of 47malignant cases revealed the mean T2 relaxtion time±SD in the malignant cases was 82.69±15.37ms, compared with 95.48±26.51ms inbenign cases,significant difference in T2 relaxtion time existed between the malignant cases and benign cases (P=0.015<0.05). In 26 cases with NAC,the mean T2 relaxtion time before NAC was 81.34±13.68ms, compared with 64.50±8.71ms after NAC.Significant difference in T2 relaxtion time existed between the pre—and post—NAC (P=0.00<0.05); Based on pathology,the mean T2 relaxtion time in 23 of 26 responders (63.18±8.37ms)was shorter than 3 of 26 non-responders(74.62±2.32ms) after NAC(P=0.029<0.05). Conclusion:T2 relaxtion time in benign lesions was found to be significantly longer than malignant lesions,The presence of T2 relaxtion time promises to help increase additional sign of breast MRI.Breast cancer after NAC was reduced in the T2relaxtion time, apparently in the responders,this was potentially useful to assess the response of NAC.