Diffusion weighted imaging in early prediction of neoadjuvant chemotherapy response in breast cancer

Abstract

Background: Neoadjuvant chemotherapy (NAC) has clinically important outcome. Early evaluation of the treatment response is important to avoid unnecessary therapy in non-responders. MRI is the most sensitive imaging for monitoring NAC response. Aim of this study: Is to test the ability of DWI to detect early response to NAC. Results: The study was performed on 20 patients, proved pathologically to have invasive breast cancer. All patients underwent breast MRI before initiation of NAC, after one cycle and after completion of the NAC protocol. Regarding the mass size, results showed no significant change in maximum mass diameters occur after the 1st NAC cycle. Absolute value of the ADC show increase all along the treatment course which has no significant correlation with the pathological response. The relative increase ADC more than 20% calculated from subtraction of the pre-treatment ADCmean value from that after the first NAC, subdividing the result on the pre-treatment ADCmean value and multiply it by 100 reflected significantly on the pathological response (p value of 0.011). Conclusion: ADC value can predict responder from non-responder as early as after the first cycle of chemotherapy.

Keywords

• Breast cancer
• Neoadjuvant
• MRI breast diffusion