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European Radiology
Published in: European Radiology 2/2010

01-02-2010 | Breast

The role of mean diffusivity (MD) as a predictive index of the response to chemotherapy in locally advanced breast cancer: a preliminary study

Authors: Chiara Iacconi, Marco Giannelli, Carolina Marini, Anna Cilotti, Monica Moretti, Paolo Viacava, Eugenia Picano, Andrea Michelotti, Davide Caramella

Published in: European Radiology | Issue 2/2010

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Abstract

Objective

To evaluate the role of mean diffusivity (MD) as a predictive index of the response to chemotherapy in locally advanced breast cancer.

Methods

Twenty-one women referred to our institution with a diagnosis of locally advanced breast cancer underwent magnetic resonance imaging (MRI) studies at 1.5 T before beginning and after completing combined neoadjuvant chemotherapy. The examination protocol included an EPI sequence sensitised to diffusion (b-value 1,000 s/mm2) and three-dimensional (3D) coronal T1 sequences before and after intravenous contrast medium. Tumours were delineated by using dynamic MR acquisition before and after chemotherapy. The percentage of tumour volume reduction (PVR) and pre-(MDpre) and post-therapy (MDpost) MD values were computed for each lesion.

Results

PVR ≥ 65% was observed in 17/21 patients (responders). MDpre of responders (0.99 ± 0.27 10−3 mm2/s) was significantly (p = 0.025) lower than MDpre of non-responders (1.46 ± 0.33 10−3 mm2/s). Moreover, in patients as a whole PVR significantly correlated (p = 0.01, r = −0.54) with MDpre. MDpost (1.26 ± 0.39 10−3 mm2/s) of responders was significantly(p = 0.024) higher than MDpre (0.99 ± 0.27 mm2 10−3 mm2/s), whereas non-responders MDpost (1.00 ± 0.14 10−3 mm2/s)did not increase compared with MDpre (1.46 ± 0.33 10−3 mm2/s).

Conclusions

This preliminary study seems to indicate that low values of pre-chemotherapy MD may identify, before starting treatment, the patients with higher probability of response in terms of percentage of volume reduction of the lesion. MD may represent a complementary parameter useful to correctly select patients for neoadjuvant chemotherapy.
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Metadata
Title
The role of mean diffusivity (MD) as a predictive index of the response to chemotherapy in locally advanced breast cancer: a preliminary study
Authors
Chiara Iacconi
Marco Giannelli
Carolina Marini
Anna Cilotti
Monica Moretti
Paolo Viacava
Eugenia Picano
Andrea Michelotti
Davide Caramella
Publication date
01-02-2010
Publisher
Springer-Verlag
Published in
European Radiology / Issue 2/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-009-1550-z

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