Dynamic contrast-enhanced MRI and sonography in patients receiving primary chemotherapy for breast cancer.
We compared dynamic contrast-enhanced MRI (DCE-MRI) and sonography (US) for monitoring tumour size in 21 patients with breast cancer undergoing primary chemotherapy (PCT) followed by surgery. The correlation between DCE-MRI and US measurements of tumour size, defined as the product of the two major diameters, was 0.555 (P=0.009), 0.782 (P<0.001), and 0.793 (P<0.001) at baseline, and after two and four cycles of PCT, respectively. The median tumour size was significantly larger when measured by DCE-MRI than by US at baseline (1472 vs 900 mm(2), P<0.001) and after two cycles of PCT (600 vs 400 mm(2), P=0.009). After PCT, the median tumour size measured by the two techniques was similar (256 vs 289 mm(2) for DCE-MRI and US, respectively, P=0.859). The correlation with the histopathological major tumour diameter was 0.824 (P<0.001) and 0.705 (P<0.001) for post-treatment DCE-MRI and US, respectively. Measurements of the final major tumour diameter by DCE-MRI tended to be more precise, including cases achieving a pathological complete response. Randomized trials are warranted to establish the clinical impact of the initial discrepancy in tumour size estimates between DCE-MRI and US, and the trend towards a better definition of the final tumour size provided by DCE-MRI in this clinical setting.
Montemurro
Filippo
F
Unit of Medical Oncology, Institute for Cancer Research and Treatment (IRCC), Strada Provinciale 142, Candiolo, Torino, Italy.
Martincich
Laura
L
De Rosa
Giovanni
G
Cirillo
Stefano
S
Marra
Vincenzo
V
Biglia
Nicoletta
N
Gatti
Marco
M
Sismondi
Piero
P
Aglietta
Massimo
M
Regge
Daniele
D
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology*; D003287:Contrast Media; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage; D018709:Statistics, Nonparametric; D016217:Ultrasonography, Mammary
D003287:Contrast Media; D004317:Doxorubicin; D017239:Paclitaxel