The role of MR spectroscopy and diffusion weighted MR imaging in evaluation of response to chemotherapy in breast cancer patients / Mirna Adel Fahmy Messiha ; Supervised Ashraf S. Selim , Sahar Mahmoud Mansour , Loay Mohammad Hassan Kassem

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Radio-diagnosis

Objective: The aim of our study was to assess the value of Diffusion weighted MRI and MRI spectroscopy in predicting early response to neoadjuvant chemotherapy (NAC) in breast cancer patients receiving neoadjuvant chemotherapy and to assess their accuracy in evaluating residual disease after NAC. Patients and Methods: This study was performed using a 1.5 T MRI system that included Thirty-three breast cancer patients. Contrast enhanced MRI, DWI and MRS were performed, all lesions were subjected to qualitative and quantitative analysis of DCE-MRI, DWI and MRS, where the lesions size, kinetic parameters, ADC values and MRS choline peak were recorded before the start of NAC, and after completion of therapy .The results of each MRI modality were correlated to the findings found at the pathology report of the complete surgical specimen. Results: The sensitivity and specificity of the MR modalities to predict pathological complete remission post NAC were 73.68% and 83.33 % respectively using kinetic curve pattern, 78.95% and 83.33 % respectively, using ADC value and finally 78.95% and 91.67 % respectively, using MRS choline peak .The sensitivity to predict pathological complete remission of combined ADC value and MRS choline peak were equal to dynamic curve pattern and ADC value sensitivity which achieved 89.47% ,this may be beneficial in cases where contrast administration is contraindicated as in renal failures, allergies or pregnant patients

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