The role of mean diffusivity (MD) as a predictive index of the response to chemotherapy in locally advanced breast cancer: a preliminary study

作者：Iacconi Chiara^*; Giannelli Marco; Marini Carolina; Cilotti Anna; Moretti Monica; Viacava Paolo; Picano Eugenia; Michelotti Andrea; Caramella Davide

来源：European Radiology, 2010, 20(2): 303-308.

DOI：10.1007/s00330-009-1550-z

• Breast
• Diffusion weighted imaging
• MRI
• Neoadjuvant chemotherapy
• Locally advanced breast cancer

To evaluate the role of mean diffusivity (MD) as a predictive index of the response to chemotherapy in locally advanced breast cancer.
Twenty-one women referred to our institution with a diagnosis of locally advanced breast cancer underwent magnetic resonance imaging (MRI) studies at 1.5 T before beginning and after completing combined neoadjuvant chemotherapy. The examination protocol included an EPI sequence sensitised to diffusion (b-value 1,000 s/mm(2)) and three-dimensional (3D) coronal T1 sequences before and after intravenous contrast medium. Tumours were delineated by using dynamic MR acquisition before and after chemotherapy. The percentage of tumour volume reduction (PVR) and pre-(MD(pre)) and post-therapy (MD(post)) MD values were computed for each lesion.
PVR a parts per thousand yen 65% was observed in 17/21 patients (responders). MD(pre) of responders (0.99 +/- 0.27 10(-3) mm(2)/s) was significantly (p = 0.025) lower than MD(pre) of non-responders (1.46 +/- 0.33 10(-3) mm(2)/s). Moreover, in patients as a whole PVR significantly correlated (p = 0.01, r = -0.54) with MD(pre). MD(post) (1.26 +/- 0.39 10(-3) mm(2)/s) of responders was significantly(p = 0.024) higher than MD(pre) (0.99 +/- 0.27 mm(2) 10(-3) mm(2)/s), whereas non-responders MD(post) (1.00 +/- 0.14 10(-3) mm(2)/s)did not increase compared with MD(pre) (1.46 +/- 0.33 10(-3) mm(2)/s).
This preliminary study seems to indicate that low values of pre-chemotherapy MD may identify, before starting treatment, the patients with higher probability of response in terms of percentage of volume reduction of the lesion. MD may represent a complementary parameter useful to correctly select patients for neoadjuvant chemotherapy.

• 出版日期2010-2