Research has shown that women who receive neoadjuvant chemotherapy are more likely to achieve breast conservation than those receiving chemotherapy after surgery. Therefore, women with breast cancer often undergo chemotherapy prior to surgery.
Now, a new study published online in the journal Radiology points to the fact that MRI provides an indication of a breast tumor’s response to presurgical chemotherapy significantly earlier than clinical examination.
When tracking a patient’s response to neoadjuvant chemotherapy, contrast-enhanced MRI offers a promising alternative to the clinical approach due to its ability to detect angiogenesis.
According to Nola M. Hylton, PhD, professor of radiology and biomedical imaging at the University of California in San Francisco, “MRI was better than the clinical approach for predicting which patients would go on to have complete tumor response. It gave us great information on early response to treatment.”
Using data from ACRIN 6657, the imaging component of the multicenter I-SPY TRIAL breast cancer trial, researchers compared MRI and clinical assessment of 216 female patients. The age of study participants ranged from 26 to 68 years. All the women were undergoing neoadjuvant chemotherapy for stage II or III breast cancer. MRI sessions were performed before, during, and after administration of a chemotherapy regimen, and the imaging results were linked with subsequent laboratory analysis of surgical samples.
Researchers discovered that MRI size measurements were superior to clinical examination at all time points, with tumor volume change showing the greatest relative benefit at the second MRI exam. The use of MRI to predict complete tumor response and residual cancer burden was optimum to the use of clinical assessment.
“What we see on imaging helps us define not just the size of the tumor but its biological activity,” Hylton said. “We can observe if the signal increases after contrast injection, and interpret that increase as angiogenic activity. We can also use water diffusion measurements with MRI to provide an indirect reflection of the density of the cells.”
Source: RSNA.