title: 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.
authors.affiliation: Department of Radiology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi 783-8505, Japan.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Iwasa
authors.affiliation: Department of Radiology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi 783-8505, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Kubota
authors.affiliation: Department of Radiology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi 783-8505, Japan.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Hamada
authors.affiliation: Department of Radiology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi 783-8505, Japan.
authors.forename: Munenobu
authors.initials: M
authors.lastname: Nogami
authors.affiliation: Department of Radiology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi 783-8505, Japan.
authors.forename: Akihito
authors.initials: A
authors.lastname: Nishioka
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000970:Antineoplastic Agents