Ciurea Anca Ileana, Bene Ioana, Cheregi Paul, Brad Thea, Ciortea Cristiana Augusta, Rusu Georgeta Mihaela, Ciule Larisa Dorina, Deac Andrada-Larisa, Lenghel Manuela Lavinia
Department of Radiology, Faculty of Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
Department of Radiology, Emergency County Hospital, 400006 Cluj-Napoca, Romania.
Diagnostics (Basel). 2024 Nov 24;14(23):2650. doi: 10.3390/diagnostics14232650.
This study investigates the role of Diffusion Tensor Imaging (DTI) in predicting the response to neoadjuvant chemotherapy (NAC) in patients with locally advanced breast cancer. A Diffusion Tensor Imaging magnetic resonance imaging (DTI MRI) sequence, evaluating water diffusion along tissue structures, was performed before and after two chemotherapy cycles. This study included 23 patients with 27 malignant masses, comparing changes in DTI parameters with Residual Cancer Burden (RCB) scores. : We found a significant correlation between changes in specific DTI parameters (e.g., λ2, FA, RA) and pathological response, suggesting that DTI could serve as a sensitive marker for early chemotherapy response. However, differences in sensitivity were observed between DTI sequences with 6 and 12 directions, indicating that 12-direction DTI may provide better diagnostic accuracy. The percentage change in DTI parameters, particularly FA, demonstrated a strong ability to predict pathological complete response (pCR) with high sensitivity. As a non-invasive tool, DTI has the potential to assess chemotherapy efficacy, although larger studies with standardized protocols are necessary to validate its clinical utility.
本研究探讨扩散张量成像（DTI）在预测局部晚期乳腺癌患者新辅助化疗（NAC）反应中的作用。在两个化疗周期前后，进行了评估沿组织结构水扩散的扩散张量成像磁共振成像（DTI MRI）序列。本研究纳入了23例患者的27个恶性肿块，将DTI参数的变化与残余癌负荷（RCB）评分进行比较。我们发现特定DTI参数（如λ2、FA、RA）的变化与病理反应之间存在显著相关性，表明DTI可作为早期化疗反应的敏感标志物。然而，观察到6方向和12方向DTI序列之间的敏感性存在差异，表明12方向DTI可能提供更好的诊断准确性。DTI参数的百分比变化，尤其是FA，具有以高敏感性预测病理完全缓解（pCR）的强大能力。作为一种非侵入性工具，DTI有潜力评估化疗疗效，尽管需要更大规模的标准化方案研究来验证其临床效用。
