title: Integration of quantitative DCE-MRI and ADC mapping to monitor treatment response in human breast cancer: initial results.
abstract: OBJECTIVE
  The objective of this study was to assess changes in the water apparent diffusion coefficient (ADC) and in pharmacokinetic parameters obtained from the fast-exchange regime (FXR) modeling of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) during neoadjuvant chemotherapy in breast cancer.
  
  
  METHODS
  Eleven patients with locally advanced breast cancer underwent MRI examination prior to and after chemotherapy but prior to surgery. A 1.5-T scanner was used to obtain T1, ADC and DCE-MRI data. DCE-MRI data were analyzed by the FXR model returning estimates of K(trans) (volume transfer constant), v(e) (extravascular extracellular volume fraction) and tau(i) (average intracellular water lifetime). Histogram and correlation analyses assessed parameter changes post-treatment.
  
  
  RESULTS
  Significant (P < .05) changes or trends towards significance (P < .10) were seen in all parameters except tau(i), although there was qualitative reduction in tau(i) values post-treatment. In particular, there was reduction (P < .035) in voxels with K(trans) values in the range 0.2-0.5 min(-1) and a decrease (P < .05) in voxels with ADC values in the range 0.99 x 10(-3) to 1.35 x 10(-3) mm2/s. ADC and v(e) were negatively correlated (r = -.60, P < .02). Parameters sensitive to water distribution and geometry (T(1), v(e), tau(i) and ADC) correlated with a multivariable linear regression model.
  
  
  CONCLUSIONS
  The analysis presented here is sensitive to longitudinal changes in breast tumor status; K(trans) and ADC are most sensitive to these changes. Relationships between parameters provide information on water distribution and geometry in the tumor environment.
authors.affiliation: Institute of Imaging Science, Vanderbilt University, Nashville, TN 37232-2310, USA. thomas.yankeelov@vanderbilt.edu
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Yankeelov
authors.forename: Martin
authors.initials: M
authors.lastname: Lepage
authors.forename: Anuradha
authors.initials: A
authors.lastname: Chakravarthy
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Broome
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Niermann
authors.forename: Mark C
authors.initials: MC
authors.lastname: Kelley
authors.forename: Ingrid
authors.initials: I
authors.lastname: Meszoely
authors.forename: Ingrid A
authors.initials: IA
authors.lastname: Mayer
authors.forename: Cheryl R
authors.initials: CR
authors.lastname: Herman
authors.forename: Kevin
authors.initials: K
authors.lastname: McManus
authors.forename: Ronald R
authors.initials: RR
authors.lastname: Price
authors.forename: John C
authors.initials: JC
authors.lastname: Gore
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000473:pathology* / Q000628:therapy*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000628:therapy; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016014:Linear Models; D020360:Neoadjuvant Therapy; D010865:Pilot Projects
chemical_list: D000970:Antineoplastic Agents; D003287:Contrast Media