| Monitoring of neoadjuvant chemotherapy using multiparametric, ²³Na sodium MR, and multimodality (PET/CT/MRI) imaging in locally advanced breast cancer. | |
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MedLine Citation:
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PMID: 21455671 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We prospectively investigated using advanced magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) to identify radiological biomarkers for treatment response in patients receiving preoperative systemic therapy (PST) for locally advanced breast cancer. Patients with a stage II or III breast cancer receiving PST were selected and underwent positron emission tomography (PET), magnetic resonance imaging (MRI), and breast biopsies at baseline and after the first cycle of PST (days 7-8) during the full course of treatment. PET/CT was acquired after injection of 2-deoxy-2-[18F]-fluoro-D-glucose (¹⁸FDG, 0.22 mCi/kg) and quantified with standardized uptake value assessment (SUV). Diagnostic breast MRI and sodium (²³Na) was acquired at 1.5 T. Total tissue sodium concentration (TSC), response criteria in solid tumors (RECIST), and volumes were quantified. Treatment response was determined by pathological assessment at surgery. Immunohistochemistry values of the proliferative index (Ki-67) were performed on biopsy specimens. Six of nineteen eligible women (43 ± 11 years) who received PST underwent radiological imaging of ¹⁸FDG-PET/CT and MRI for at least two cycles of treatment. Five patients had a pathological partial response (pPR) and one had pathological non-response (pNR). TSC decreased 21% in responders with increases in the non-responder (P = 0.03). Greater reduction in SUV was observed in responders (38%) compared to the non-responder (22%; P = 0.03). MRI volumes decreased after cycle 1 by 42% (responders) and 35% (non-responder; P = 0.11). Proliferation index Ki-67 declined in responders in the first cycle (median = 47%, range = 29-20%), but increased (4%) in the non-responder. Significant decreases in TSC, SUV, and Ki-67 were observed in responders with increases in TSC and Ki-67 in non-responders. Our results demonstrate the feasibility of using multi-modality proton, ²³Na MRI, and PET/CT metrics as radiological biomarkers for monitoring response to PST in patients with operable breast cancer. |
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Authors:
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Michael A Jacobs; Ronald Ouwerkerk; Antonio C Wolff; Edward Gabrielson; Hind Warzecha; Stacie Jeter; David A Bluemke; Richard Wahl; Vered Stearns |
Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2011-04-01 |
Journal Detail:
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Title: Breast cancer research and treatment Volume: 128 ISSN: 1573-7217 ISO Abbreviation: Breast Cancer Res. Treat. Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-06-15 Completed Date: 2011-12-07 Revised Date: 2012-05-07 |
Medline Journal Info:
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Nlm Unique ID: 8111104 Medline TA: Breast Cancer Res Treat Country: Netherlands |
Other Details:
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Languages: eng Pagination: 119-26 Citation Subset: IM |
Affiliation:
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The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA. mikej@mri.jhu.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Antineoplastic Agents / pharmacology* Antineoplastic Combined Chemotherapy Protocols / therapeutic use Breast Neoplasms / drug therapy, radiography*, radionuclide imaging* Carcinoma, Ductal, Breast / drug therapy, radiography*, radionuclide imaging* Carcinoma, Lobular / diagnosis*, drug therapy Cyclophosphamide / administration & dosage Doxorubicin / administration & dosage Drug Monitoring Female Fluorodeoxyglucose F18 / diagnostic use Humans Magnetic Resonance Imaging Middle Aged Neoadjuvant Therapy Positron-Emission Tomography Prospective Studies Radiopharmaceuticals / diagnostic use Sodium Isotopes Taxoids / administration & dosage* Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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5P30CA006973/CA/NCI NIH HHS; P50CA103175/CA/NCI NIH HHS; P50CA88843/CA/NCI NIH HHS; R01 CA100184-01A2/CA/NCI NIH HHS; R01CA100184/CA/NCI NIH HHS; U01CA070095/CA/NCI NIH HHS; U01CA140204/CA/NCI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antineoplastic Agents; 0/Radiopharmaceuticals; 0/Sodium Isotopes; 0/Taxoids; 114977-28-5/docetaxel; 23214-92-8/Doxorubicin; 50-18-0/Cyclophosphamide; 63503-12-8/Fluorodeoxyglucose F18 |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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