Breast MRI Helps Predict Chemo’s Effectiveness

MRIs are superior to clinical examination in indicating breast tumor response to pre-surgical chemotherapy, according to a study published online in the journal Radiology.

Women undergoing neoadjuvant chemotherapy, chemotherapy prior to surgery, are traditionally monitored through clinical measurements of the tumor’s size and location. Contrast-enhanced MRI can detect blood vessel formation in tumors, angiogenesis, which is an earlier and more accurate marker of tumor response, researchers found.

To determine MRI effectiveness, researchers from the University of California in San Francisco, analyzed data from ACRIN 6657, the imaging component of the multicenter Investigation of Serial Studies to Predict Your Therapeutic Response with Imaging And moLecular Analysis (I-SPY TRIAL) breast cancer trial. The researchers compared MRI and clinical assessments of 216 female patients who were undergoing neoadjuvant chemotherapy for stage II or III breast cancer.

Researchers found that the MRI measurements, taken before, during and after chemotherapy, were superior to clinical examination at all time points. Tumor volume change showed the greatest relative benefit at the second MRI exam.

“What we see on imaging helps us define not just the size of the tumor but its biological activity,” said Nola. M. Hylton, PhD, professor of radiology and biomedical imaging at the university. “We can observe if the signal increases after contrast injection, and interpret that increase as angiogenic activity. We can also use water diffusion measurements with MRI to provide an indirect reflection of the density of the cells.”