title: Detection of Post-Therapeutic Effects in Breast Carcinoma Using Hard X-Ray Index of Refraction Computed Tomography - A Feasibility Study.
abstract: OBJECTIVE
  Neoadjuvant chemotherapy is the state-of-the-art treatment in advanced breast cancer. A correct visualization of the post-therapeutic tumor size is of high prognostic relevance. X-ray phase-contrast computed tomography (PC-CT) has been shown to provide improved soft-tissue contrast at a resolution formerly restricted to histopathology, at low doses. This study aimed at assessing ex-vivo the potential use of PC-CT for visualizing the effects of neoadjuvant chemotherapy on breast carcinoma.
  
  
  METHODS
  The analysis was performed on two ex-vivo formalin-fixed mastectomy samples containing an invasive carcinoma removed from two patients treated with neoadjuvant chemotherapy. Images were matched with corresponding histological slices. The visibility of typical post-therapeutic tissue changes was assessed and compared to results obtained with conventional clinical imaging modalities.
  
  
  RESULTS
  PC-CT depicted the different tissue types with an excellent correlation to histopathology. Post-therapeutic tissue changes were correctly visualized and the residual tumor mass could be detected. PC-CT outperformed clinical imaging modalities in the detection of chemotherapy-induced tissue alterations including post-therapeutic tumor size.
  
  
  CONCLUSIONS
  PC-CT might become a unique diagnostic tool in the prediction of tumor response to neoadjuvant chemotherapy. PC-CT might be used to assist during histopathological diagnosis, offering a high-resolution and high-contrast virtual histological tool for the accurate delineation of tumor boundaries.
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Grandl
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.
authors.forename: Anikó
authors.initials: A
authors.lastname: Sztrókay-Gaul
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.|Department of Physics, Ludwig-Maximilians-University, Garching, Germany.
authors.forename: Alberto
authors.initials: A
authors.lastname: Mittone
authors.affiliation: Department of Physics, Ludwig-Maximilians-University, Garching, Germany.|ANKA Synchrotron Radiation Facility, Karlsruhe Institute for Technology, Eggenstein, Germany.
authors.forename: Sergey
authors.initials: S
authors.lastname: Gasilov
authors.affiliation: Department of Physics, Ludwig-Maximilians-University, Garching, Germany.|European Synchrotron Radiation Facility, Grenoble, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Brun
authors.affiliation: European Synchrotron Radiation Facility, Grenoble, France.
authors.forename: Alberto
authors.initials: A
authors.lastname: Bravin
authors.affiliation: Institute of Pathology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.
authors.forename: Doris
authors.initials: D
authors.lastname: Mayr
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.
authors.forename: Sigrid D
authors.initials: SD
authors.lastname: Auweter
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Hellerhoff
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Reiser
authors.affiliation: Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany.|Department of Physics, Ludwig-Maximilians-University, Garching, Germany.
authors.forename: Paola
authors.initials: P
authors.lastname: Coan
mesh_terms: D000970:Antineoplastic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001940:Breast / Q000000981:diagnostic imaging* / Q000473:pathology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020360:Neoadjuvant Therapy; D016707:Tissue Fixation; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents