Wu Li-An, Chang Ruey-Feng, Huang Chiun-Sheng, Lu Yen-Shen, Chen Hong-Hao, Chen Jo-Yu, Chang Yeun-Chung
Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Department of Medical Imaging, Taipei City Hospital, Heping, Branch, Taipei, Taiwan.
J Magn Reson Imaging. 2015 Nov;42(5):1407-20. doi: 10.1002/jmri.24915. Epub 2015 Apr 15.
To evaluate the treatment response of locally advanced breast cancer (LABC) to neoadjuvant chemotherapy using magnetic resonance (MR) vascular maps and apparent diffusion coefficient (ADC) at 3T. Materials and Methods Thirty-one patients with LABC who underwent breast MR studies before, after the first course, and after completing neoadjuvant chemotherapy were enrolled. Vascular morphology was retrieved via Hessian matrix and the voxels of the vessels and volume of vessels were measured automatically. Whole tumor mean ADC values were calculated. Clinical responders were defined as >50% tumor reduction in the final MR studies. Pathologically complete responders were also recorded.
There were 21 clinical responders and 10 nonresponders. Compared to the nonresponders after the first course, the responders were characterized by more vascular reduction of the breast lesion and decreased bilateral vascular discrepancy (voxels and volume), and increments in the ADC value and ADC percentage of the lesions (all P < 0.05). There were three pathological complete responders who showed more apparent early vascular reduction of the lesion breast (voxels and volume) and increments in the ADC value than others (P = 0.02, 0.01 and 0.02, respectively).
The early changes of MR vascular maps and ADC are associated with the final treatment response of LABC.
利用3T磁共振（MR）血管图和表观扩散系数（ADC）评估局部晚期乳腺癌（LABC）对新辅助化疗的治疗反应。材料与方法 纳入31例LABC患者，这些患者在新辅助化疗的第1疗程前、第1疗程后及完成新辅助化疗后均接受了乳腺MR检查。通过黑塞矩阵获取血管形态，并自动测量血管的体素和血管体积。计算整个肿瘤的平均ADC值。临床缓解者定义为在最终MR检查中肿瘤缩小>50%。记录病理完全缓解者。
有21例临床缓解者和10例无反应者。与第1疗程后的无反应者相比，缓解者的特征为乳腺病变的血管减少更多、双侧血管差异（体素和体积）减小，以及病变的ADC值和ADC百分比增加（均P<0.05）。有3例病理完全缓解者，其病变乳腺的早期血管减少（体素和体积）比其他患者更明显，且ADC值增加（分别为P = 0.02、0.01和0.02）。
MR血管图和ADC的早期变化与LABC的最终治疗反应相关。
