Basak Erguvan Dogan MD, Presenter: Nothing to Disclose

Qing Yuan, Abstract Co-Author: Nothing to Disclose

Edward F. Jackson PhD, Abstract Co-Author: Nothing to Disclose

Inanc Guvenc MD, Abstract Co-Author: Nothing to Disclose

Roland Bassett, Abstract Co-Author: Nothing to Disclose

Massimo Cristofanilli MD, Abstract Co-Author: Nothing to Disclose

Gary J. Whitman MD, Abstract Co-Author: Nothing to Disclose

To assess the association of dynamic contrast enhanced breast MRI pharmacokinetic (PK) parameters with pathological response and patient survival in women treated with neoadjuvant chemotherapy.

PK analysis of 66 patients with locally advanced breast cancer (LABC) who underwent MRI monitoring of response to neoadjuvant chemotherapy (NACR) was retrospectively performed. Baseline values and changes in Ktrans, Kep, Ve, from the baseline MRI study to the initial post-chemotherapy MRI and changes in the time-intensity curve (maximum slope, contrast enhancement ratio (CER) and area under the enhancement curve during 90 seconds after enhancement (ΔAUC90)) from baseline to the initial post-chemotherapy MRI were obtained. Tumor size changes measured as changes in tumor volume (ΔV), single maximal dimension (max) and response evaluation criteria in solid tumors (RECIST) (ΔR) were recorded. Spearman correlation test was used to assess the association between continuous size and PK parameters, and regression analysis was used to assess the association with 5-year survival.

Higher Ve values at baseline were associated with greater decreases in tumor size (p=0.008). Changes in Ktrans and AUC90 values were the strongest predictors of NACR. ΔAUC90 (p<0.005) and ΔR (p<0.005) were independently associated with pathological response. The only parameter significantly associated with 5-year survival was ΔR (p=0.001, 95% CI). We found a trend towards statistical significance for ΔVe and ΔKtrans, with greater changes associated with better survival.

Changes in Ktrans and AUC90 were helpful in predicting NACR; however they did not show significant associations with survival. Tumor size change measured by RECIST criteria had a stronger correlation with 5-year survival. Larger studies are needed to further explore the association of changes in Ktrans and Ve with patient survival

PK analysis may have a role in predicting NACR in breast tumors. However, change in tumor size remains the strongest predictor of patient survival.

Dogan, B, Yuan, Q, Jackson, E, Guvenc, I, Bassett, R, Cristofanilli, M, Whitman, G, Role of MRI Pharmacokinetic Analysis in the Prediction of Response to Neoadjuvant Chemotherapy and Patient Survival in Breast Cancer.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034296.html