Neoadjuvant chemotherapy is now widely used in the management of locally advanced breast cancer (LABC). Early initiation of systemic therapy can improve overall and disease-free survival for patients with LABC or inflammatory cancer. MR imaging with intravenous contrast and advanced MR imaging techniques provide new opportunities for assessing tumor morphologic changes, tumor vascularity, tumor cellularity, and tumor metabolic features. MR imaging is more reliable than the conventional methods in the assessment of tumor size and vascularity changes during and after chemotherapy. The addition of advanced imaging techniques to further characterize tumor cellularity and metabolic features appears promising. However, there is still no consensus on the role of MR imaging for assessing response to neoadjuvant chemotherapy or on a standardized MR imaging examination in patients receiving neoadjuvant chemotherapy.
"The extent of FDG uptake by lesions smaller than twice the quoted resolution of PET is often underestimated . Both DCE-MRI and DCE-CT have shown potentials as functional imaging tools to early assess tumor response to chemotherapy by detecting tumor blood perfusion changes , –. Although DCE-MRI offers relatively good sensitivity and spatial resolution in soft tissue imaging, the spatial resolution must be traded off to get a sufficient frame rate for dynamic tracking of the contrast agent in order to perform whole organ scans with functional imaging information . "
[Show abstract][Hide abstract] ABSTRACT: There is a strong need to assess early tumor response to chemotherapy in order to avoid adverse effects from unnecessary chemotherapy and allow early transition to second-line therapy. This study was to quantify tumor perfusion changes with dynamic contrast-enhanced ultrasound (CEUS) in the evaluation of early tumor response to cytotoxic chemotherapy. Sixty nude mice bearing with MCF-7 breast cancer were administrated with either adriamycin or sterile saline. CEUS was performed on days 0, 2, 4 and 6 of the treatment, in which time-signal intensity (SI) curves were obtained from the intratumoral and depth-matched liver parenchyma. Four perfusion parameters including peak enhancement (PE), area under the curve of wash-in (WiAUC), wash-in rate (WiR) and wash-in perfusion index (WiPI) were calculated from perfusion curves and normalized with respect to perfusion of adjacent liver parenchyma. Histopathological analysis was conducted to evaluate tumor perfusion, tumor cell density, microvascular density (MVD) and proliferating cell density. Significant decreases of tumor normalized perfusion parameters (i.e., nPE, nWiAUC, nWiR and nWiPI) were noticed between adriamycin-treated and control groups (<0.01) 2 days after therapy. There were significant differences of tumor volumes between control and treated groups on day 6 (<0.001) while there were no significant differences in tumor volume on days 0, 2 and 4 (>0.05). Significant decreases of tumor perfusion, tumor cell density, MVD and proliferating cell density were seen in adrianycin-treated group 2 days after therapy when compared to control group (<0.001). Dynamic CEUS for quantification of tumor perfusion could be used for early detection of cancer response to cytotoxic chemotherapy prior to notable tumor shrinkage.
PLoS ONE 05/2013; 8(3):e58274. DOI:10.1371/journal.pone.0058274 · 3.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The use of color vision as a tool for machine vision provides a powerful means of performing rapid, accurate inspection of microelectronic structures. Since microelectronics fabrication is in large part a thin film technology, and since thin films have characteristic colors, this approach extends the range of optical analysis possible. We have constructed a color vision system used to measure thin film dielectric materials. Color matching is performed rapidly (<100 msecs) and with resolution better than 20 Å. The resolution limit has been so far set only by the samples available for measurement. We have further extended the capability of the system beyond simple color matching to identify true unknown samples whose thickness fall within the range of the original system database. Feed-back control of the illumination has been incorporated into the system; we present data on the effect of shifts in lighting or magnification. Microscopic, as well as broad area measurements (for uniformity) can be made.
Robotics and Automation. Proceedings. 1987 IEEE International Conference on; 04/1987
[Show abstract][Hide abstract] ABSTRACT: The objective of our study was to determine the relative accuracy of mammography, sonography, and MRI in predicting residual tumor after neoadjuvant chemotherapy for breast cancer as compared with the gold standards of physical examination and pathology.
Forty-one women with stage IIB-III palpable breast cancer were prospectively enrolled in a study investigating the effects of sequential single-agent chemotherapy (doxorubicin followed by paclitaxel or vice versa) on tumor imaging. The study cohort consisted of the first 31 patients (age range, 31-65 years; mean, 45 years) who completed the protocol. All underwent physical examination, mammography, sonography, and MRI before and after receiving each neoadjuvant chemotherapeutic drug. Imaging studies were reviewed by two radiologists using conventional lexicons for lesion analysis, and the findings were compared with clinical response and pathology results.
Complete, partial, and stable clinical response as defined by clinical examination was seen in 15, 14, and two of the 31 patients, respectively. Agreement rates about the degree of response were 32%, 48%, and 55%, respectively, for mammography, sonography, and MRI compared with clinical evaluation and did not differ statistically. Agreement about the rate of response as measured by clinical examination, mammography, sonography, and MRI compared with the gold standard (pathology) was 19%, 26%, 35%, and 71%, respectively. Of the four, MRI agreed with the gold standard significantly more often (p < 0.002 for all three paired comparisons with MRI). When there was disagreement with the gold standard, none of the four exhibited a significant tendency to either under- or overestimate.
MRI appears to provide the best correlation with pathology-better than physical examination, mammography, and sonography-in patients undergoing neoadjuvant chemotherapy. However, MRI may overestimate (6%) or underestimate (23%) residual disease in approximately 29% of the patients (95% confidence interval, 14-48%).
American Journal of Roentgenology 04/2005; 184(3):868-77. DOI:10.2214/ajr.184.3.01840868 · 2.73 Impact Factor
A Martínez-Esteve, R M Álvarez-Pérez, L Caballero-Gullón, M P Sancho-Márquez, I Borrego-Dorado,
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