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

Background: With the expansion of the use of the neoadjuvant chemotherapy(NAC) in locally advanced breast cancer (LABC), both dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) and 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET CT) are promising methods for assessment of the tumor response during chemotherapy. Objective: to evaluate the diagnostic accuracy of DCE-MRI of breast &18 F-FDG PETCT regarding the assessment of response to NAC in locally advanced breast cancer patients and evaluate their performance as predictive modalities to pathological response. Methods: Forty patients with locally advanced breast cancer who underwent NAC were screened, however twenty-five only were included in final statistical analysis. Both PET/CT and DCE-MRI were performed before and after two {u2013}three cycles NAC. Response to NAC was assessed using different PET-CT parameters as well as size measurements and functional parameters by DCE-MRI. Patients were classified into pCR and non pCR. PET/CT and MRI findings were compared in correlation to post-operative pathology.Results: The pooled sensitivity and specificity of MRI in assessment LABC response to neoadjuvant therapy in correlation with pathological data were 100% (p<0.001) and 12.5% (p=0.18) respectively. The corresponding values for PET/CT were 94.1% (p<0.001) and 25% (p=0.18), however the estimated overall accuracy for both MRI and PETCT was the same measuring 72%. The sensitivity and specificity of MRI in assessment axillary lymph nodes response to neoadjuvant therapy in correlation with pathological data were 83% and 50% respectively

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