High resolution in vivo characterization of apparent diffusion coefficient at the tumor-stromal boundary of breast carcinomas: a pilot study to assess treatment response using proximity-dependent diffusion-weighted imaging.
OBJECTIVE
To evaluate diffusion changes in the breast tumor-stromal boundary and adjacent tissue in response to neoadjuvant chemotherapy using high resolution diffusion-weighted imaging (HR-DWI).


METHODS
Seven patients with invasive breast cancer were imaged with HR-DWI before and early during treatment. The mean apparent diffusion coefficient (ADC) was plotted in 1-mm increments around the tumor boundary. Early change in ADC was measured for tumor, tumor boundary, and stromal regions, and the relationship to treatment response was evaluated using Spearman's correlation.


RESULTS
Statistically significant correlations between treatment response and early changes in ADC were found for: (i) whole tumor (ρ = 0.93, 95% confidence interval [CI] = (0.58, 0.99), P = 0.003); (ii) tumor rim (ρ = 0.75, 95% CI = (-0.007, 0.96), P = 0.05); and (iii) boundary transition region (ρ = 0.86, 95% CI = (0.29, 0.98), P = 0.01). Early change in ADC of distal stroma had a marginally statistically significant positive correlation to treatment response (ρ = 0.71, 95% CI = (-0.084, 0.95), P = 0.07).


CONCLUSIONS
Proximity-dependent evaluation of HR-DWI data in the breast tumor-stromal boundary and adjacent tissue may provide information about response to therapy.
The UC Berkeley - UCSF Graduate Program in Bioengineering, San Francisco and Berkeley, California, USA; Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA.
Rebekah L
RL
McLaughlin
David C
DC
Newitt
Lisa J
LJ
Wilmes
Ella F
EF
Jones
Dorota J
DJ
Wisner
John
J
Kornak
Evelyn
E
Proctor
Bonnie N
BN
Joe
Nola M
NM
Hylton
D000465:Algorithms; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D001952:Bridged-Ring Compounds / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D009361:Neoplasm Invasiveness; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome
D001952:Bridged-Ring Compounds; D043823:Taxoids; C080625:taxane; D004317:Doxorubicin
DWI; MRI; breast cancer; neoadjuvant chemotherapy