Blood oxygen level-dependent MRI for the monitoring of neoadjuvant chemotherapy in breast carcinoma: initial experience

Purpose

To determine the feasibility of using R2? map MRI for pretreatment diagnosis and monitoring of tumor response to neoadjuvant chemotherapy (NAC) in patients with breast cancer.

Material and Methods

Twenty-eight women with breast cancer, as evidenced by pathology, underwent MR imaging prior to and after chemotherapy. All patients were examined by conventional MRI and R2? map imaging. Subjects were divided into major histological response (MHR) and non-major histological response (NMHR) groups. Mean R2? values of cancerous and normal glandular tissues were measured before and following NAC. Differences in R2? and ΔR2?% values between these two groups were compared with paired or independent t tests. The relationship between ΔR2?% and histological response was examined using Spearman's correlation test.

Results

Before NAC, the average R2? values in carcinoma were lower than in normal glandular tissue (P<.05). After two to four cycles of NAC, the R2? values in carcinoma were increased (P<.05 ), but this change was not significant in normal glandular tissue. After NAC, ΔR2?% was significantly higher in MHR as compared to NMHR (P<.05). The ΔR2?% correlated with the histological response (r=0.581, P<.01).

Conclusion

In women undergoing NAC for breast cancer treatment, R2? and ΔR2?% appear to provide predictive information of tumor response which is probably associated with changes in tumor angiogenesis and tissue oxygenation. R2? map imaging of breasts may therefore be useful in monitoring tumor response to NAC.