Multiparametric Magnetic Resonance Imaging, Spectroscopy and Multinuclear (23 Na) Imaging Monitoring of Preoperative Chemotherapy for Locally Advanced Breast Cancer

Rationale and Objectives The aim of this prospective study was to investigate using multiparametric and multinuclear magnetic resonance imaging during preoperative systemic therapy for locally advanced breast cancer. Materials and Methods Women with operable stage 2 or 3 breast cancer who received p...

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Veröffentlicht in:Academic radiology 2010-12, Vol.17 (12), p.1477-1485
Hauptverfasser: Jacobs, Michael A., PhD, Stearns, Vered, MD, Wolff, Antonio C., MD, Macura, Katarzyna, MD, PhD, Argani, Pedram, MD, Khouri, Nagi, MD, Tsangaris, Theodore, MD, Barker, Peter B., DPhil, Davidson, Nancy E., MD, Bhujwalla, Zaver M., PhD, Bluemke, David A., MD, PhD, Ouwerkerk, Ronald, PhD
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container_end_page 1485
container_issue 12
container_start_page 1477
container_title Academic radiology
container_volume 17
creator Jacobs, Michael A., PhD
Stearns, Vered, MD
Wolff, Antonio C., MD
Macura, Katarzyna, MD, PhD
Argani, Pedram, MD
Khouri, Nagi, MD
Tsangaris, Theodore, MD
Barker, Peter B., DPhil
Davidson, Nancy E., MD
Bhujwalla, Zaver M., PhD
Bluemke, David A., MD, PhD
Ouwerkerk, Ronald, PhD
description Rationale and Objectives The aim of this prospective study was to investigate using multiparametric and multinuclear magnetic resonance imaging during preoperative systemic therapy for locally advanced breast cancer. Materials and Methods Women with operable stage 2 or 3 breast cancer who received preoperative systemic therapy were studied using dynamic contrast-enhanced magnetic resonance imaging, magnetic resonance spectroscopy, and23 Na magnetic resonance. Quantitative metrics of choline peak signal-to-noise ratio, total tissue sodium concentration, tumor volumes, and Response Evaluation Criteria in Solid Tumors were determined and compared to final pathologic results using receiver-operating characteristic analysis. Hormonal markers were investigated. Statistical significance was set at P < .05. Results Eighteen eligible women were studied. Fifteen responded to therapy, four (22%) with pathologic complete response and 11 (61%) with pathologic partial response. Three patients (17%) had no response. Among estrogen receptor–positive, HER2-positive, and triple-negative phenotypes, observed frequencies of pathologic complete response, pathologic partial response, and no response were 2, 5, and 0; 1, 4, and 0; and 1, 1, and 3, respectively. Responders (pathologic complete response and pathologic partial response) had the largest reductions in choline signal-to-noise ratio (35%, from 7.2 ± 2.3 to 4.6 ± 2; P < .01) compared to nonresponders (11%, from 8.4 ± 2.7 to 7.5 ± 3.6; P = .13) after the first cycle. Total tissue sodium concentration significantly decreased in responders (27%, from 66 ± 18 to 48.4 ± 8 mmol/L; P  = .01), while there was little change in nonresponders (51.7 ± 7.6 to 56.5 ± 1.6 mmol/L; P = .50). Lesion volume decreased in responders (40%, from 78 ± 78 to 46 ± 51 mm3 ; P = .01) and nonresponders (21%, from 100 ± 104 to 79.2 ± 87 mm3 ; P = .23) after the first cycle. The largest reduction in Response Evaluation Criteria in Solid Tumors occurred after the first treatment in responders (18%, from 24.5 ± 20 to 20.2 ± 18 mm; P = .01), with a slight decrease in tumor diameter noted in nonresponders (17%, from 23 ± 19 to 19.2 ± 19.1 mm; P = .80). Conclusions Multiparametric and multinuclear imaging parameters were significantly reduced after the first cycle of preoperative systemic therapy in responders, specifically, choline signal-to-noise ratio and sodium. These new surrogate radiologic biomarkers maybe able to predict and provide a platform for
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Materials and Methods Women with operable stage 2 or 3 breast cancer who received preoperative systemic therapy were studied using dynamic contrast-enhanced magnetic resonance imaging, magnetic resonance spectroscopy, and23 Na magnetic resonance. Quantitative metrics of choline peak signal-to-noise ratio, total tissue sodium concentration, tumor volumes, and Response Evaluation Criteria in Solid Tumors were determined and compared to final pathologic results using receiver-operating characteristic analysis. Hormonal markers were investigated. Statistical significance was set at P &lt; .05. Results Eighteen eligible women were studied. Fifteen responded to therapy, four (22%) with pathologic complete response and 11 (61%) with pathologic partial response. Three patients (17%) had no response. Among estrogen receptor–positive, HER2-positive, and triple-negative phenotypes, observed frequencies of pathologic complete response, pathologic partial response, and no response were 2, 5, and 0; 1, 4, and 0; and 1, 1, and 3, respectively. Responders (pathologic complete response and pathologic partial response) had the largest reductions in choline signal-to-noise ratio (35%, from 7.2 ± 2.3 to 4.6 ± 2; P &lt; .01) compared to nonresponders (11%, from 8.4 ± 2.7 to 7.5 ± 3.6; P = .13) after the first cycle. Total tissue sodium concentration significantly decreased in responders (27%, from 66 ± 18 to 48.4 ± 8 mmol/L; P  = .01), while there was little change in nonresponders (51.7 ± 7.6 to 56.5 ± 1.6 mmol/L; P = .50). Lesion volume decreased in responders (40%, from 78 ± 78 to 46 ± 51 mm3 ; P = .01) and nonresponders (21%, from 100 ± 104 to 79.2 ± 87 mm3 ; P = .23) after the first cycle. The largest reduction in Response Evaluation Criteria in Solid Tumors occurred after the first treatment in responders (18%, from 24.5 ± 20 to 20.2 ± 18 mm; P = .01), with a slight decrease in tumor diameter noted in nonresponders (17%, from 23 ± 19 to 19.2 ± 19.1 mm; P = .80). Conclusions Multiparametric and multinuclear imaging parameters were significantly reduced after the first cycle of preoperative systemic therapy in responders, specifically, choline signal-to-noise ratio and sodium. These new surrogate radiologic biomarkers maybe able to predict and provide a platform for potential adaptive therapy in patients.</description><identifier>ISSN: 1076-6332</identifier><identifier>EISSN: 1878-4046</identifier><identifier>DOI: 10.1016/j.acra.2010.07.009</identifier><identifier>PMID: 20863721</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>23Na ; Adolescent ; Adult ; advanced cancer ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; Breast ; Breast Neoplasms - diagnostic imaging ; Breast Neoplasms - drug therapy ; Breast Neoplasms - surgery ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Staging ; Prospective Studies ; proton ; Radiography ; Radiology ; Sodium ; sodium MR ; spectroscopy</subject><ispartof>Academic radiology, 2010-12, Vol.17 (12), p.1477-1485</ispartof><rights>AUR</rights><rights>2010 AUR</rights><rights>Copyright © 2010 AUR. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c575t-66d5454b0f82775eb4156e2fd9283aa2cb699d417737e9c18c061c5f1241f9163</citedby><cites>FETCH-LOGICAL-c575t-66d5454b0f82775eb4156e2fd9283aa2cb699d417737e9c18c061c5f1241f9163</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.acra.2010.07.009$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3548,27922,27923,45993</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20863721$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jacobs, Michael A., PhD</creatorcontrib><creatorcontrib>Stearns, Vered, MD</creatorcontrib><creatorcontrib>Wolff, Antonio C., MD</creatorcontrib><creatorcontrib>Macura, Katarzyna, MD, PhD</creatorcontrib><creatorcontrib>Argani, Pedram, MD</creatorcontrib><creatorcontrib>Khouri, Nagi, MD</creatorcontrib><creatorcontrib>Tsangaris, Theodore, MD</creatorcontrib><creatorcontrib>Barker, Peter B., DPhil</creatorcontrib><creatorcontrib>Davidson, Nancy E., MD</creatorcontrib><creatorcontrib>Bhujwalla, Zaver M., PhD</creatorcontrib><creatorcontrib>Bluemke, David A., MD, PhD</creatorcontrib><creatorcontrib>Ouwerkerk, Ronald, PhD</creatorcontrib><title>Multiparametric Magnetic Resonance Imaging, Spectroscopy and Multinuclear (23 Na) Imaging Monitoring of Preoperative Chemotherapy for Locally Advanced Breast Cancer</title><title>Academic radiology</title><addtitle>Acad Radiol</addtitle><description>Rationale and Objectives The aim of this prospective study was to investigate using multiparametric and multinuclear magnetic resonance imaging during preoperative systemic therapy for locally advanced breast cancer. Materials and Methods Women with operable stage 2 or 3 breast cancer who received preoperative systemic therapy were studied using dynamic contrast-enhanced magnetic resonance imaging, magnetic resonance spectroscopy, and23 Na magnetic resonance. Quantitative metrics of choline peak signal-to-noise ratio, total tissue sodium concentration, tumor volumes, and Response Evaluation Criteria in Solid Tumors were determined and compared to final pathologic results using receiver-operating characteristic analysis. Hormonal markers were investigated. Statistical significance was set at P &lt; .05. Results Eighteen eligible women were studied. Fifteen responded to therapy, four (22%) with pathologic complete response and 11 (61%) with pathologic partial response. Three patients (17%) had no response. Among estrogen receptor–positive, HER2-positive, and triple-negative phenotypes, observed frequencies of pathologic complete response, pathologic partial response, and no response were 2, 5, and 0; 1, 4, and 0; and 1, 1, and 3, respectively. Responders (pathologic complete response and pathologic partial response) had the largest reductions in choline signal-to-noise ratio (35%, from 7.2 ± 2.3 to 4.6 ± 2; P &lt; .01) compared to nonresponders (11%, from 8.4 ± 2.7 to 7.5 ± 3.6; P = .13) after the first cycle. Total tissue sodium concentration significantly decreased in responders (27%, from 66 ± 18 to 48.4 ± 8 mmol/L; P  = .01), while there was little change in nonresponders (51.7 ± 7.6 to 56.5 ± 1.6 mmol/L; P = .50). Lesion volume decreased in responders (40%, from 78 ± 78 to 46 ± 51 mm3 ; P = .01) and nonresponders (21%, from 100 ± 104 to 79.2 ± 87 mm3 ; P = .23) after the first cycle. The largest reduction in Response Evaluation Criteria in Solid Tumors occurred after the first treatment in responders (18%, from 24.5 ± 20 to 20.2 ± 18 mm; P = .01), with a slight decrease in tumor diameter noted in nonresponders (17%, from 23 ± 19 to 19.2 ± 19.1 mm; P = .80). Conclusions Multiparametric and multinuclear imaging parameters were significantly reduced after the first cycle of preoperative systemic therapy in responders, specifically, choline signal-to-noise ratio and sodium. These new surrogate radiologic biomarkers maybe able to predict and provide a platform for potential adaptive therapy in patients.</description><subject>23Na</subject><subject>Adolescent</subject><subject>Adult</subject><subject>advanced cancer</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Combined Chemotherapy Protocols</subject><subject>Breast</subject><subject>Breast Neoplasms - diagnostic imaging</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Breast Neoplasms - surgery</subject><subject>Female</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Prospective Studies</subject><subject>proton</subject><subject>Radiography</subject><subject>Radiology</subject><subject>Sodium</subject><subject>sodium MR</subject><subject>spectroscopy</subject><issn>1076-6332</issn><issn>1878-4046</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9Ul1v0zAUjRATG4M_wAPyGyCR4o_ETqRp0qiATWoBMXi2XOemdUnsYDuV-n_4oTh0mxgPe_K1fc659jk3y14QPCOY8HfbmdJezShOB1jMMK4fZSekElVe4II_TjUWPOeM0ePsaQhbjEnJK_YkO6a44kxQcpL9Xo5dNIPyqofojUZLtbYQU_ENgrPKakBXvVobu36LrgfQ0bug3bBHyjboL9mOugPl0WvK0Gf15haOls6a6PxUuhZ99eAG8CqaHaD5BnoXN2mbhFrn0cJp1XV7dNHsppYNeu9BhYjm084_y45a1QV4frOeZj8-fvg-v8wXXz5dzS8WuS5FGXPOm7IoixVuKypECasi_Rdo29S0YkpRveJ13RRECCag1qTSmBNdtoQWpK0JZ6fZ-UF3GFc9NBps9KqTgze98nvplJH3b6zZyLXbSVakDESdBF7dCHj3a4QQZW-Chq5TFtwYpOCM8JIxkZD0gNTJz-ChvetCsJzSlVs5pSundCUWMqWbSC__fd8d5TbOBDg7ACC5tDPgZdAGJkONT9HJxpmH9c__o-vOWJOi-Ql7CFs3epv8l0QGKrG8nuZrGi-CMS4IYewPStDNzg</recordid><startdate>20101201</startdate><enddate>20101201</enddate><creator>Jacobs, Michael A., PhD</creator><creator>Stearns, Vered, MD</creator><creator>Wolff, Antonio C., MD</creator><creator>Macura, Katarzyna, MD, PhD</creator><creator>Argani, Pedram, MD</creator><creator>Khouri, Nagi, MD</creator><creator>Tsangaris, Theodore, MD</creator><creator>Barker, Peter B., DPhil</creator><creator>Davidson, Nancy E., MD</creator><creator>Bhujwalla, Zaver M., PhD</creator><creator>Bluemke, David A., MD, PhD</creator><creator>Ouwerkerk, Ronald, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20101201</creationdate><title>Multiparametric Magnetic Resonance Imaging, Spectroscopy and Multinuclear (23 Na) Imaging Monitoring of Preoperative Chemotherapy for Locally Advanced Breast Cancer</title><author>Jacobs, Michael A., PhD ; Stearns, Vered, MD ; Wolff, Antonio C., MD ; Macura, Katarzyna, MD, PhD ; Argani, Pedram, MD ; Khouri, Nagi, MD ; Tsangaris, Theodore, MD ; Barker, Peter B., DPhil ; Davidson, Nancy E., MD ; Bhujwalla, Zaver M., PhD ; Bluemke, David A., MD, PhD ; Ouwerkerk, Ronald, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c575t-66d5454b0f82775eb4156e2fd9283aa2cb699d417737e9c18c061c5f1241f9163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>23Na</topic><topic>Adolescent</topic><topic>Adult</topic><topic>advanced cancer</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Combined Chemotherapy Protocols</topic><topic>Breast</topic><topic>Breast Neoplasms - diagnostic imaging</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Breast Neoplasms - surgery</topic><topic>Female</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Prospective Studies</topic><topic>proton</topic><topic>Radiography</topic><topic>Radiology</topic><topic>Sodium</topic><topic>sodium MR</topic><topic>spectroscopy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jacobs, Michael A., PhD</creatorcontrib><creatorcontrib>Stearns, Vered, MD</creatorcontrib><creatorcontrib>Wolff, Antonio C., MD</creatorcontrib><creatorcontrib>Macura, Katarzyna, MD, PhD</creatorcontrib><creatorcontrib>Argani, Pedram, MD</creatorcontrib><creatorcontrib>Khouri, Nagi, MD</creatorcontrib><creatorcontrib>Tsangaris, Theodore, MD</creatorcontrib><creatorcontrib>Barker, Peter B., DPhil</creatorcontrib><creatorcontrib>Davidson, Nancy E., MD</creatorcontrib><creatorcontrib>Bhujwalla, Zaver M., PhD</creatorcontrib><creatorcontrib>Bluemke, David A., MD, PhD</creatorcontrib><creatorcontrib>Ouwerkerk, Ronald, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Academic radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jacobs, Michael A., PhD</au><au>Stearns, Vered, MD</au><au>Wolff, Antonio C., MD</au><au>Macura, Katarzyna, MD, PhD</au><au>Argani, Pedram, MD</au><au>Khouri, Nagi, MD</au><au>Tsangaris, Theodore, MD</au><au>Barker, Peter B., DPhil</au><au>Davidson, Nancy E., MD</au><au>Bhujwalla, Zaver M., PhD</au><au>Bluemke, David A., MD, PhD</au><au>Ouwerkerk, Ronald, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multiparametric Magnetic Resonance Imaging, Spectroscopy and Multinuclear (23 Na) Imaging Monitoring of Preoperative Chemotherapy for Locally Advanced Breast Cancer</atitle><jtitle>Academic radiology</jtitle><addtitle>Acad Radiol</addtitle><date>2010-12-01</date><risdate>2010</risdate><volume>17</volume><issue>12</issue><spage>1477</spage><epage>1485</epage><pages>1477-1485</pages><issn>1076-6332</issn><eissn>1878-4046</eissn><abstract>Rationale and Objectives The aim of this prospective study was to investigate using multiparametric and multinuclear magnetic resonance imaging during preoperative systemic therapy for locally advanced breast cancer. Materials and Methods Women with operable stage 2 or 3 breast cancer who received preoperative systemic therapy were studied using dynamic contrast-enhanced magnetic resonance imaging, magnetic resonance spectroscopy, and23 Na magnetic resonance. Quantitative metrics of choline peak signal-to-noise ratio, total tissue sodium concentration, tumor volumes, and Response Evaluation Criteria in Solid Tumors were determined and compared to final pathologic results using receiver-operating characteristic analysis. Hormonal markers were investigated. Statistical significance was set at P &lt; .05. Results Eighteen eligible women were studied. Fifteen responded to therapy, four (22%) with pathologic complete response and 11 (61%) with pathologic partial response. Three patients (17%) had no response. Among estrogen receptor–positive, HER2-positive, and triple-negative phenotypes, observed frequencies of pathologic complete response, pathologic partial response, and no response were 2, 5, and 0; 1, 4, and 0; and 1, 1, and 3, respectively. Responders (pathologic complete response and pathologic partial response) had the largest reductions in choline signal-to-noise ratio (35%, from 7.2 ± 2.3 to 4.6 ± 2; P &lt; .01) compared to nonresponders (11%, from 8.4 ± 2.7 to 7.5 ± 3.6; P = .13) after the first cycle. Total tissue sodium concentration significantly decreased in responders (27%, from 66 ± 18 to 48.4 ± 8 mmol/L; P  = .01), while there was little change in nonresponders (51.7 ± 7.6 to 56.5 ± 1.6 mmol/L; P = .50). Lesion volume decreased in responders (40%, from 78 ± 78 to 46 ± 51 mm3 ; P = .01) and nonresponders (21%, from 100 ± 104 to 79.2 ± 87 mm3 ; P = .23) after the first cycle. The largest reduction in Response Evaluation Criteria in Solid Tumors occurred after the first treatment in responders (18%, from 24.5 ± 20 to 20.2 ± 18 mm; P = .01), with a slight decrease in tumor diameter noted in nonresponders (17%, from 23 ± 19 to 19.2 ± 19.1 mm; P = .80). Conclusions Multiparametric and multinuclear imaging parameters were significantly reduced after the first cycle of preoperative systemic therapy in responders, specifically, choline signal-to-noise ratio and sodium. These new surrogate radiologic biomarkers maybe able to predict and provide a platform for potential adaptive therapy in patients.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>20863721</pmid><doi>10.1016/j.acra.2010.07.009</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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source MEDLINE; ScienceDirect Journals (5 years ago - present)
subjects 23Na
Adolescent
Adult
advanced cancer
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
Breast
Breast Neoplasms - diagnostic imaging
Breast Neoplasms - drug therapy
Breast Neoplasms - surgery
Female
Humans
Magnetic Resonance Imaging
Middle Aged
Neoplasm Staging
Prospective Studies
proton
Radiography
Radiology
Sodium
sodium MR
spectroscopy
title Multiparametric Magnetic Resonance Imaging, Spectroscopy and Multinuclear (23 Na) Imaging Monitoring of Preoperative Chemotherapy for Locally Advanced Breast Cancer
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