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DW-MRI ADC values can predict treatment response in patients with locally advanced breast cancer undergoing neoadjuvant chemotherapy

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Abstract

The purpose of this study was to evaluate the importance of diffusion-weighted magnetic resonance imaging (DW-MRI) apparent diffusion coefficient (ADC) values to predict treatment response to neoadjuvant chemotherapy (NCT) in patients with locally advanced breast cancer (LABC). Thirty-two patients with LABC underwent 2–4 cylces of NCT (docetaxel and epirubicin). The DW-MRI scans were performed within one week prior to chemotherapy and after the first course of treatment, respectively. Accordingly, tumor volumes, changes in tumor ADC values, and their degree of correlation were analyzed. The overall response (OR) was observed in 62.5% (95% CI, 45.7–79.3%) of patients after 2 cycles of NCT. The clinical complete response (CR) rate and pathological CR (pCR) rate were 15.6 and 9.4%, respectively. The stable disease (SD) rate was 34.4% (11 patients), and progressive disease (PD) was observed in only one patient (3.1%). After the first cycle of NCT, the ADC values in the CR + PR group significantly increased (P < 0.001). The initial ADC values before chemotherapy in the OR group were significantly lower than those in the SD + PD group (P < 0.001). The initial ADC values and the changes in tumor volume after chemotherapy were negatively correlated (r = −0.58, P = 0.02). The lower the initial tumor ADC value was the more obvious the decrease in tumor volume after chemotherapy. The changes in ADC values of tumors after chemotherapy and the changes in tumor volume were positively correlated (r = 0.96, P < 0.001). After chemotherapy, the greater the change in ADC value, the more the tumor volume was reduced. Using the initial ADC values of breast cancer tumors and the early changes in ADC values after NCT, we may be able to predict tumor response to chemotherapy. Tumors with low initial ADC values may be sensitive to chemotherapy; tumors with significantly increasing ADC values early after chemotherapy may be sensitive to chemotherapy.

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Acknowledgments

This study is supported in part by Chinese Army Medical High-tech Important Research Fund (2010GXJS092). The authors have no commercial, proprietary, or financial interest in the products or companies described in this article.

Conflict of interest

None. The authors have no commercial, proprietary, or financial interest in the products or companies described in this article.

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Authors and Affiliations

  1. Division of Breast Surgery, Department of General Surgery, General Hospital of Chinese People’s Liberation Army, No. 28, Fuxing Rd, 100853, Beijing, People’s Republic of China

    Xi-ru Li, Yan-jun Zhang, Jian-dong Wang, Jie Li, Yi-qiong Zheng & Lei Liu

  2. Division of MRI, Department of Radiology, General Hospital of Chinese People’s Liberation Army, No. 28, Fuxing Rd, 100853, Beijing, People’s Republic of China

    Liu-quan Cheng & Ai-lian Zhang

  3. Department of Pathology, General Hospital of Chinese People’s Liberation Army, Beijing, People’s Republic of China

    Mei Liu & Xin Song

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  1. Xi-ru Li
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  2. Liu-quan Cheng
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  3. Mei Liu
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  4. Yan-jun Zhang
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  5. Jian-dong Wang
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  7. Xin Song
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  8. Jie Li
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  9. Yi-qiong Zheng
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  10. Lei Liu
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Correspondence to Xi-ru Li or Liu-quan Cheng.

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Xi-ru Li and Liu-quan Cheng contributed equally to this article.

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Li, Xr., Cheng, Lq., Liu, M. et al. DW-MRI ADC values can predict treatment response in patients with locally advanced breast cancer undergoing neoadjuvant chemotherapy. Med Oncol 29, 425–431 (2012). https://doi.org/10.1007/s12032-011-9842-y

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  • DOI: https://doi.org/10.1007/s12032-011-9842-y

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