Diffusion MRI methods for improved treatment monitoring in breast cancer.

摘要

As of the time of this writing, the gold standard for monitoring primary breast tumor response to chemotherapy treatment is clinical examination based on palpable changes in tumor size. This method is non--quantitative, highly subjective and generally imposes that treatment is completed before efficacy can be assessed, defeating the purpose of monitoring and eliminating the prospect of adaptive treatment.;MRI methods including tissue enhancement kinetics are increasingly used to provide improved monitoring of treatment response in breast and other cancers. In this work, I investigate the added value of diffusion weighted imaging, an MRI technique, for treatment monitoring in breast cancer. This investigation was first conducted in a thoroughly characterized animal model of breast cancer and subsequently in breast cancer patients.;I furthered this work by exploring the potential benefit of diffusion tensor imaging, an MRI technique relatively novel to breast imaging, for breast cancer treatment monitoring. To achieve this, I developed a facile MRI protocol which was also used to study the effect of modulating diffusion time on diffusion measurements.;I found that diffusion weighted imaging parameters were sensitive to treatment induced changes both in an animal model of breast cancer and in breast cancer patients. Diffusion tensor imaging parameters were able to distinguish normal breast tissue from breast cancer but modulating the diffusion time did not result in any significant changes in diffusion measurements.