TY - JOUR
T1 - Dynamic Contrast-enhanced and Diffusion-weighted Magnetic Resonance Imaging for Response Evaluation After Single-Dose Ablative Neoadjuvant Partial Breast Irradiation
AU - Vasmel, Jeanine E.
AU - Groot Koerkamp, Maureen L.
AU - Mandija, Stefano
AU - Veldhuis, Wouter B.
AU - Moman, Maaike R.
AU - Froeling, Martijn
AU - van der Velden, Bas H.M.
AU - Charaghvandi, Ramona K.
AU - Vreuls, Celien P.H.
AU - van Diest, Paul J.
AU - van Leeuwen, A. M.Gijs
AU - van Gorp, Joost
AU - Philippens, Marielle E.P.
AU - van Asselen, Bram
AU - Lagendijk, Jan J.W.
AU - Verkooijen, Helena M.
AU - van den Bongard, H. J.G.Desirée
AU - Houweling, Antonetta C.
N1 - Funding Information:
Disclosures: Drs van den Bongard and van Asselen received funding from Pink Ribbon/Koningin Wilhelmina Fonds voor de Nederlandse Kankerbestrijding (2012.WO22.C154).
Publisher Copyright:
© 2021 The Authors
PY - 2022/4/8
Y1 - 2022/4/8
N2 - Purpose: We aimed to evaluate changes in dynamic contrast-enhanced (DCE) and diffusion-weighted (DW) magnetic resonance imaging (MRI) scans acquired before and after single-dose ablative neoadjuvant partial breast irradiation (NA-PBI), and explore the relation between semiquantitative MRI parameters and radiologic and pathologic responses.Methods and Materials: We analyzed 3.0T DCE and DW-MRI of 36 patients with low-risk breast cancer who were treated with single-dose NA-PBI, followed by breast-conserving surgery 6 or 8 months later. MRI was acquired before NA-PBI and 1 week, 2, 4, and 6 months after NA-PBI. Breast radiologists assessed the radiologic response and breast pathologists scored the pathologic response after surgery. Patients were grouped as either pathologic responders or nonresponders (<10% vs ≥10% residual tumor cells). The semiquantitative MRI parameters evaluated were time to enhancement (TTE), 1-minute relative enhancement (RE
1min), percentage of enhancing voxels (%EV), distribution of washout curve types, and apparent diffusion coefficient (ADC).
Results: In general, the enhancement increased 1 week after NA-PBI (baseline vs 1 week median - TTE: 15s vs 10s; RE
1min: 161% vs 197%; %EV: 47% vs 67%) and decreased from 2 months onward (6 months median - TTE: 25s; RE
1min: 86%; %EV: 12%). Median ADC increased from 0.83 × 10
-3 mm
2/s at baseline to 1.28 × 10
-3 mm
2/s at 6 months. TTE, RE
1min, and %EV showed the most potential to differentiate between radiologic responses, and TTE, RE
1min, and ADC between pathologic responses.
Conclusions: Semiquantitative analyses of DCE and DW-MRI showed changes in relative enhancement and ADC 1 week after NA-PBI, indicating acute inflammation, followed by changes indicating tumor regression from 2 to 6 months after radiation therapy. A relation between the MRI parameters and radiologic and pathologic responses could not be proven in this exploratory study.
AB - Purpose: We aimed to evaluate changes in dynamic contrast-enhanced (DCE) and diffusion-weighted (DW) magnetic resonance imaging (MRI) scans acquired before and after single-dose ablative neoadjuvant partial breast irradiation (NA-PBI), and explore the relation between semiquantitative MRI parameters and radiologic and pathologic responses.Methods and Materials: We analyzed 3.0T DCE and DW-MRI of 36 patients with low-risk breast cancer who were treated with single-dose NA-PBI, followed by breast-conserving surgery 6 or 8 months later. MRI was acquired before NA-PBI and 1 week, 2, 4, and 6 months after NA-PBI. Breast radiologists assessed the radiologic response and breast pathologists scored the pathologic response after surgery. Patients were grouped as either pathologic responders or nonresponders (<10% vs ≥10% residual tumor cells). The semiquantitative MRI parameters evaluated were time to enhancement (TTE), 1-minute relative enhancement (RE
1min), percentage of enhancing voxels (%EV), distribution of washout curve types, and apparent diffusion coefficient (ADC).
Results: In general, the enhancement increased 1 week after NA-PBI (baseline vs 1 week median - TTE: 15s vs 10s; RE
1min: 161% vs 197%; %EV: 47% vs 67%) and decreased from 2 months onward (6 months median - TTE: 25s; RE
1min: 86%; %EV: 12%). Median ADC increased from 0.83 × 10
-3 mm
2/s at baseline to 1.28 × 10
-3 mm
2/s at 6 months. TTE, RE
1min, and %EV showed the most potential to differentiate between radiologic responses, and TTE, RE
1min, and ADC between pathologic responses.
Conclusions: Semiquantitative analyses of DCE and DW-MRI showed changes in relative enhancement and ADC 1 week after NA-PBI, indicating acute inflammation, followed by changes indicating tumor regression from 2 to 6 months after radiation therapy. A relation between the MRI parameters and radiologic and pathologic responses could not be proven in this exploratory study.
UR - http://www.scopus.com/inward/record.url?scp=85123254243&partnerID=8YFLogxK
U2 - 10.1016/j.adro.2021.100854
DO - 10.1016/j.adro.2021.100854
M3 - Article
C2 - 35387418
AN - SCOPUS:85123254243
SN - 2452-1094
VL - 7
SP - 1
EP - 11
JO - Advances in Radiation Oncology
JF - Advances in Radiation Oncology
IS - 2
M1 - 100854
ER -