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Diffusion Weighted Imaging (DWI) for Early Prediction of Treatment Response in Locally Advanced Breast Cancer (LABC)

Rachel Aideyan, Sophie Davis School of Biomedical Education at the City College of New York, 160 Convent Ave, New York, NY, 10031 Dr. Dilip Giri, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065 Dr. Sunitha Thakur, Department of Medical Physics, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065

Purpose 

LABC is when breast cancer has spread beyond the skin but not to other organs. To treat LABC neoadjuvant chemotherapy (NAC) must be administered: chemotherapy given before surgery. It is essential to determine if LABC is responding to NAC as early as possible. NAC response is assessed by measuring change in tumor dimensions on conventional MRI, but these changes may take time. We conducted a literature review to determine if DWI enables early and accurate assessment to NAC response in LABC. 


Methods

The PubMed database was used with the search terms “DWI”, “MRI”, “LABC”,  and “NAC”. Lesions were segmented by drawing a region of interest to calculate apparent diffusion coefficient (ADC) values, with high ADC (>1.3 mm2/s) interpreted as benign and low ADC (<1.3 mm2/s) as malignant. Increase in ADC is a favorable treatment response.  All cases had surgery and pathologic analysis after NAC; a pathologic complete response (pCR) was defined as no cancer on the post-NAC surgical specimen.  


Results 

62 women with LABC who had NAC were evaluated. MRI with DWI was performed before treatment (MR1), after 1 NAC cycle (MR2), and after NAC completion (MR3). They had breast surgery after NAC completion; 39% had pCR. Percent increase in ADC between MR1 and MR2 was higher in the pCR group. Sensitivity was 83%, specificity was 84%, and accuracy was 84% for early prediction of pCR after NAC.  

Conclusion 

Our literature review suggests that DWI may enable early prediction of treatment response to NAC in LABC, potentially enabling women to be given more effective treatment and spared toxicity.  Study of new technologies would help to determine if use of additional quantitative variables could further enhance accuracy in early prediction of NAC response in LABC.

 

 

 

 

 




Additional Abstract Information

Presenter: Rachel Aideyan

Institution: The City College of New York

Type: Poster

Subject: Health & Human Development

Status: Approved


Time and Location

Session: Poster 7
Date/Time: Tue 3:30pm-4:30pm
Session Number: 5133