Document Detail

Frequent optical imaging during breast cancer neoadjuvant chemotherapy reveals dynamic tumor physiology in an individual patient.
MedLine Citation:
PMID:  20542448     Owner:  NLM     Status:  MEDLINE    
RATIONALE AND OBJECTIVES: Imaging tumor response to neoadjuvant chemotherapy in vivo offers unique opportunities for patient care and clinical decision-making. Detailed imaging studies may allow oncologists to optimize therapeutic drug type and dose based on individual patient response. Most radiologic methods are used sparingly because of cost; thus, important functional information about tumor response dynamics may be missed. In addition, current clinical standards are based on determining tumor size changes; thus, standard anatomic imaging may be insensitive to early or frequent biochemical responses. Because optical methods provide functional imaging end points, our objective is to develop a low-barrier-to-access bedside approach that can be used for frequent, functional assessment of dynamic tumor physiology in individual patients.
MATERIALS AND METHODS: Diffuse Optical Spectroscopic Imaging (DOSI) is a noninvasive, bedside functional imaging technique that quantifies the concentration and molecular state of tissue hemoglobin, water, and lipid. Pilot clinical studies have shown that DOSI may be a useful tool for quantifying neoadjuvant chemotherapy response, typically by comparing the degree of change in tumor water and deoxy-hemoglobin concentration before and after therapy. Patient responses at 1 week and mid-therapy have been used to predict clinical outcome. In this report, we assess the potential value of frequent DOSI monitoring by performing measurements on 19 different days in a 51-year-old subject with infiltrating ductal carcinoma (initial tumor size 60 x 27 mm) who received neoadjuvant chemotherapy (anthracyclines and bevacizumab) over an 18-week period.
RESULTS: A composite index, the Tissue Optical Index (TOI), showed a significant ( approximately 50%) decrease over the nearly 18 weeks of chemotherapy. Tumor response was sensitive to the type of chemotherapy agent, and functional indices fluctuated in a manner consistent with dynamic tumor physiology. Final pathology revealed 4 mm of residual disease, which was detectible by DOSI at the conclusion of chemotherapy before surgery.
CONCLUSION: This case study suggests that DOSI may be a bedside-capable tool for frequent longitudinal monitoring of therapeutic functional response to neoadjuvant chemotherapy.
Albert E Cerussi; Vaya W Tanamai; Rita S Mehta; David Hsiang; John Butler; Bruce J Tromberg
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-06-12
Journal Detail:
Title:  Academic radiology     Volume:  17     ISSN:  1878-4046     ISO Abbreviation:  Acad Radiol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-05     Completed Date:  2010-08-04     Revised Date:  2014-09-24    
Medline Journal Info:
Nlm Unique ID:  9440159     Medline TA:  Acad Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1031-9     Citation Subset:  IM    
Copyright Information:
2010 AUR. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Angiogenesis Inhibitors / therapeutic use
Antibodies, Monoclonal / therapeutic use
Antibodies, Monoclonal, Humanized
Breast Neoplasms / diagnosis*,  drug therapy
Carcinoma, Ductal, Breast / diagnosis*,  drug therapy
Chemotherapy, Adjuvant
Diagnosis, Computer-Assisted
Middle Aged
Neoadjuvant Therapy*
Spectroscopy, Near-Infrared*
Grant Support
2P30CA62203/CA/NCI NIH HHS; P30 CA062203/CA/NCI NIH HHS; P41 RR001192/RR/NCRR NIH HHS; P41 RR001192-26/RR/NCRR NIH HHS; P41 RR001192-27/RR/NCRR NIH HHS; P41 RR001192-28/RR/NCRR NIH HHS; P41 RR001192-29/RR/NCRR NIH HHS; P41 RR001192-30/RR/NCRR NIH HHS; P41 RR001192-305021/RR/NCRR NIH HHS; P41 RR001192-31/RR/NCRR NIH HHS; P41-RR01192/RR/NCRR NIH HHS; R01 CA142989/CA/NCI NIH HHS; R01 CA142989-01/CA/NCI NIH HHS; R01 CA142989-02/CA/NCI NIH HHS; U54 CA105480/CA/NCI NIH HHS; U54 CA105480-01/CA/NCI NIH HHS; U54 CA105480-02/CA/NCI NIH HHS; U54 CA105480-03/CA/NCI NIH HHS; U54 CA105480-04/CA/NCI NIH HHS; U54 CA105480-05/CA/NCI NIH HHS; U54 CA136400/CA/NCI NIH HHS; U54 CA136400-01/CA/NCI NIH HHS; U54-CA105480/CA/NCI NIH HHS; U54CA136400/CA/NCI NIH HHS
Reg. No./Substance:
0/Angiogenesis Inhibitors; 0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 2S9ZZM9Q9V/bevacizumab

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