Volume 30, Issue 2, 2021
DOI: 10.24205/03276716.2020.4098
The role of magnetic resonance diffusion weighted imaging in evaluating perioperative chemotherapy for breast cancer
Abstract
Dynamic monitoring of chemotherapy efficacy during perioperative period of breast cancer has great clinical significance. Diffusion-weighted magnetic resonance imaging (DW-MRI) is sensitive to changes of microenvironment after tumor treatment. Therefore, we aim to explore the value of DW-MRI in breast cancer after chemotherapy. 62 breast cancer patients who received neoadjuvant chemotherapy were subjected to conventional MRI plain scan and DW examination one week before and after chemotherapy. The tumor response to chemotherapy was divided into pCR and non-pCR efficacy groups. The ADC values of apparent diffusion coefficients were measured on DWI images. No significant differences in ADC value before treatment with histological grade and molecular subtype were found (p> 0.05). The best predicted pCR?ADC% cutoff was 25%. When using DWIMRI, the cutoff has a sensitivity of 83%, specificity 84%, PPV 77%, and NPV 89%. Compared with that before chemotherapy, ADC value was significantly increased after chemotherapy and the change of ADC before and after chemotherapy was positively correlated with the change of long diameter, short diameter and average diameter (P <0.05). ADC value in pCR group and non-pCR group before chemotherapy had a negative correlation with the rate of change in the length and diameter (P <0.05). In conclusion, ADC value can sensitively reflect the early changes after chemotherapy in breast cancer and is helpful for the early and dynamic monitoring of the treatment efficacy
Keywords
ADC, breast cancer, perioperative period