title: Evaluation of the treatment response to neoadjuvant chemotherapy in locally advanced breast cancer using combined magnetic resonance vascular maps and apparent diffusion coefficient.
abstract: OBJECTIVE
  To evaluate the treatment response of locally advanced breast cancer (LABC) to neoadjuvant chemotherapy using magnetic resonance (MR) vascular maps and apparent diffusion coefficient (ADC) at 3T. Materials and Methods Thirty-one patients with LABC who underwent breast MR studies before, after the first course, and after completing neoadjuvant chemotherapy were enrolled. Vascular morphology was retrieved via Hessian matrix and the voxels of the vessels and volume of vessels were measured automatically. Whole tumor mean ADC values were calculated. Clinical responders were defined as >50% tumor reduction in the final MR studies. Pathologically complete responders were also recorded.
  
  
  RESULTS
  There were 21 clinical responders and 10 nonresponders. Compared to the nonresponders after the first course, the responders were characterized by more vascular reduction of the breast lesion and decreased bilateral vascular discrepancy (voxels and volume), and increments in the ADC value and ADC percentage of the lesions (all P < 0.05). There were three pathological complete responders who showed more apparent early vascular reduction of the lesion breast (voxels and volume) and increments in the ADC value than others (P = 0.02, 0.01 and 0.02, respectively).
  
  
  CONCLUSIONS
  The early changes of MR vascular maps and ADC are associated with the final treatment response of LABC.
authors: Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.|Department of Medical Imaging, Taipei City Hospital, Heping, Branch, Taipei, Taiwan.
authors: Li-An
authors: LA
authors: Wu
authors: Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan.
authors: Ruey-Feng
authors: RF
authors: Chang
authors: Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors: Chiun-Sheng
authors: CS
authors: Huang
authors: Department of Oncology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors: Yen-Shen
authors: YS
authors: Lu
authors: Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan.
authors: Hong-Hao
authors: HH
authors: Chen
authors: Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors: Jo-Yu
authors: JY
authors: Chen
authors: Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors: Yeun-Chung
authors: YC
authors: Chang
mesh_terms: D000328:Adult; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D017024:Chemotherapy, Adjuvant; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009942:Organometallic Compounds; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol
keywords: automatic vascular mapping; diffusion-weighted image; early response monitoring; locally advanced breast cancer; magnetic resonance vascular maps; neoadjuvant chemotherapy