Can unenhanced MRI of the breast replace contrast-enhanced MRI in assessing response to neoadjuvant chemotherapy?
Cavallo Marincola, Beatrice
Acta radiologica (Stockholm, Sweden : 1987)
Taylor & Francis
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Cavallo Marincola, B., Telesca, M., Zaccagna, F., Riemer, F., Anzidei, M., Catalano, C., & Pediconi, F. (2019). Can unenhanced MRI of the breast replace contrast-enhanced MRI in assessing response to neoadjuvant chemotherapy?. Acta radiologica (Stockholm, Sweden : 1987), 60 (1), 35-44. https://doi.org/10.1177/0284185118773512
Background: The goals of neoadjuvant chemotherapy (NAC) are to reduce tumor volume and to offer a prognostic indicator in assessing treatment response. Contrast-enhanced Magnetic Resonance Imaging (CE-MRI) is an established method for evaluating response to NAC in patients with breast cancer. Purpose: To validate the role of unenhanced MRI (ue-MRI) compared to CE-MRI for assessing response to NAC in women with breast cancer. Material and methods: 71 patients with an ongoing NAC for breast cancer underwent MRI before, during and at the end of NAC. Ue-MRI was performed with T2 weighted sequence with iterative decomposition of water and fat and diffusion-weighted sequences. CE-MRI was performed using 3D T1-weighted sequences before and after administration of gadobenate dimeglumine. Two blinded observers rated ue-MRI and CE-MRI for the evaluation of tumor response. Statistical analysis was performed to compare lesion size and ADC values changes during therapy, as well as inter-observer agreement. Results: There were not statistically significant differences between ue-MRI and CE-MRI sequences for evaluation of lesion size at baseline and after every cycle of treatment (p>0.05). The mean tumor ADC values at baseline and across the cycles of NAC were significantly different for responder group. Conclusion: Ue-MRI can achieve similar results to CE-MRI for the assessment of tumor response to NAC. ADC values can differentiate responders from non-responders.
Breast, Humans, Breast Neoplasms, Meglumine, Organometallic Compounds, Contrast Media, Magnetic Resonance Imaging, Image Enhancement, Treatment Outcome, Chemotherapy, Adjuvant, Neoadjuvant Therapy, Reproducibility of Results, Adult, Aged, Middle Aged, Female
External DOI: https://doi.org/10.1177/0284185118773512
This record's URL: https://www.repository.cam.ac.uk/handle/1810/278590