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Microwave imaging for neoadjuvant chemotherapy monitoring: initial clinical experience.

Meaney PM, Kaufman PA, Muffly LS, Click M, Poplack SP, Wells WA, Schwartz GN, di Florio-Alexander RM, Tosteson TD, Li Z, Geimer SD, Fanning MW, Zhou T, Epstein NR, Paulsen KD - Breast Cancer Res. (2013)

Bottom Line: Two patient cases (one complete and one partial response) are presented in detail and demonstrate changes in microwave properties commensurate with the degree of treatment response observed pathologically.Normalized mean conductivity in ROIs from patients with complete pathological responses was significantly different from that of partial responders (P value = 0.004).In addition, the normalized conductivity measure also correlated well with complete pathological response at 30 days (P value = 0.002).

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ABSTRACT

Introduction: Microwave tomography recovers images of tissue dielectric properties, which appear to be specific for breast cancer, with low-cost technology that does not present an exposure risk, suggesting the modality may be a good candidate for monitoring neoadjuvant chemotherapy.

Methods: Eight patients undergoing neoadjuvant chemotherapy for locally advanced breast cancer were imaged longitudinally five to eight times during the course of treatment. At the start of therapy, regions of interest (ROIs) were identified from contrast-enhanced magnetic resonance imaging studies. During subsequent microwave examinations, subjects were positioned with their breasts pendant in a coupling fluid and surrounded by an immersed antenna array. Microwave property values were extracted from the ROIs through an automated procedure and statistical analyses were performed to assess short term (30 days) and longer term (four to six months) dielectric property changes.

Results: Two patient cases (one complete and one partial response) are presented in detail and demonstrate changes in microwave properties commensurate with the degree of treatment response observed pathologically. Normalized mean conductivity in ROIs from patients with complete pathological responses was significantly different from that of partial responders (P value = 0.004). In addition, the normalized conductivity measure also correlated well with complete pathological response at 30 days (P value = 0.002).

Conclusions: These preliminary findings suggest that both early and late conductivity property changes correlate well with overall treatment response to neoadjuvant therapy in locally advanced breast cancer. This result is consistent with earlier clinical outcomes that lesion conductivity is specific to differentiating breast cancer from benign lesions and normal tissue.

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1300 MHz microwave tomographic images. Imaging planes five to seven are shown corresponding to the three closest planes to the nipple with the permittivity on the top row and conductivity on the bottom row. (a) Left (contralateral) breast prior to treatment, (b) right (ipsilateral) breast prior to treatment, (c) right breast 44 days into treatment, and (d) right breast immediately prior to surgery.
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Figure 3: 1300 MHz microwave tomographic images. Imaging planes five to seven are shown corresponding to the three closest planes to the nipple with the permittivity on the top row and conductivity on the bottom row. (a) Left (contralateral) breast prior to treatment, (b) right (ipsilateral) breast prior to treatment, (c) right breast 44 days into treatment, and (d) right breast immediately prior to surgery.

Mentions: MT was conducted prior to the start of therapy, five other times during treatment and just prior to surgery. Figure 3 shows the recovered, en face permittivity and conductivity images for anatomically coronal planes 5, 6 and 7 (Plane 1 is closest to the chestwall and subsequent planes move away in 1 cm increments) for (a) the left (contralateral) breast before chemotherapy, (b) the right (ipsilateral) breast before chemotherapy, (c) the right breast at day 44, and (d) the right breast after therapy. For the left breast, the tissue boundary is readily evident and decreases in size from plane 5 to 7 as expected. Both permittivity (εr) and conductivity (σ) images show the breast exhibiting relative low values with a somewhat elevated central region most likely associated with higher water-content fibroglandular tissue [31].


Microwave imaging for neoadjuvant chemotherapy monitoring: initial clinical experience.

Meaney PM, Kaufman PA, Muffly LS, Click M, Poplack SP, Wells WA, Schwartz GN, di Florio-Alexander RM, Tosteson TD, Li Z, Geimer SD, Fanning MW, Zhou T, Epstein NR, Paulsen KD - Breast Cancer Res. (2013)

1300 MHz microwave tomographic images. Imaging planes five to seven are shown corresponding to the three closest planes to the nipple with the permittivity on the top row and conductivity on the bottom row. (a) Left (contralateral) breast prior to treatment, (b) right (ipsilateral) breast prior to treatment, (c) right breast 44 days into treatment, and (d) right breast immediately prior to surgery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3672734&req=5

Figure 3: 1300 MHz microwave tomographic images. Imaging planes five to seven are shown corresponding to the three closest planes to the nipple with the permittivity on the top row and conductivity on the bottom row. (a) Left (contralateral) breast prior to treatment, (b) right (ipsilateral) breast prior to treatment, (c) right breast 44 days into treatment, and (d) right breast immediately prior to surgery.
Mentions: MT was conducted prior to the start of therapy, five other times during treatment and just prior to surgery. Figure 3 shows the recovered, en face permittivity and conductivity images for anatomically coronal planes 5, 6 and 7 (Plane 1 is closest to the chestwall and subsequent planes move away in 1 cm increments) for (a) the left (contralateral) breast before chemotherapy, (b) the right (ipsilateral) breast before chemotherapy, (c) the right breast at day 44, and (d) the right breast after therapy. For the left breast, the tissue boundary is readily evident and decreases in size from plane 5 to 7 as expected. Both permittivity (εr) and conductivity (σ) images show the breast exhibiting relative low values with a somewhat elevated central region most likely associated with higher water-content fibroglandular tissue [31].

Bottom Line: Two patient cases (one complete and one partial response) are presented in detail and demonstrate changes in microwave properties commensurate with the degree of treatment response observed pathologically.Normalized mean conductivity in ROIs from patients with complete pathological responses was significantly different from that of partial responders (P value = 0.004).In addition, the normalized conductivity measure also correlated well with complete pathological response at 30 days (P value = 0.002).

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Introduction: Microwave tomography recovers images of tissue dielectric properties, which appear to be specific for breast cancer, with low-cost technology that does not present an exposure risk, suggesting the modality may be a good candidate for monitoring neoadjuvant chemotherapy.

Methods: Eight patients undergoing neoadjuvant chemotherapy for locally advanced breast cancer were imaged longitudinally five to eight times during the course of treatment. At the start of therapy, regions of interest (ROIs) were identified from contrast-enhanced magnetic resonance imaging studies. During subsequent microwave examinations, subjects were positioned with their breasts pendant in a coupling fluid and surrounded by an immersed antenna array. Microwave property values were extracted from the ROIs through an automated procedure and statistical analyses were performed to assess short term (30 days) and longer term (four to six months) dielectric property changes.

Results: Two patient cases (one complete and one partial response) are presented in detail and demonstrate changes in microwave properties commensurate with the degree of treatment response observed pathologically. Normalized mean conductivity in ROIs from patients with complete pathological responses was significantly different from that of partial responders (P value = 0.004). In addition, the normalized conductivity measure also correlated well with complete pathological response at 30 days (P value = 0.002).

Conclusions: These preliminary findings suggest that both early and late conductivity property changes correlate well with overall treatment response to neoadjuvant therapy in locally advanced breast cancer. This result is consistent with earlier clinical outcomes that lesion conductivity is specific to differentiating breast cancer from benign lesions and normal tissue.

Show MeSH
Related in: MedlinePlus