MR tomographic evaluation of the effectiveness of neoadjuvant chemotherapy for breast cancer based on pharmacokinetic numerical analysis of tumor uptake of paramagnetic contrast in intravenous contrast enhancement
https://doi.org/10.18705/2311-4495-2024-11-5-428-444
EDN: ERFXXC
Abstract
Background. In clinical practice, MRI pathophysiological and pharmacokinetic models with calculations of contrast transport indicators are unacceptably little used.
Aim of the study. To propose a pharmacokinetic technique for the quantitative assessment of primary tumors and metastases, the effectiveness of breast cancer chemotherapy (BC), from dynamic contrast enhancement MRI. Material and methods. 18 patients were included who underwent neoadjuvant chemotherapy (NACHT) in four cycles for breast cancer T1-3N0-1M0, followed by radical surgical removal of the tumor. According to the results of a three — year follow-up, patients with a relapse — free course (n = 11) formed group 1, and seven patients with detected metastatic lesions (3 in the liver, 2 in the lungs, 2 in the brain) — group 2. For the initial 120–180 s of MRI with contrast after the injection of a paramagnetic, the simplification is valid for concentrations in tumor and blood and for tranfer coefficient: d{СОПУХОЛЬ(t)} / dt = ККр-Оп * СКРОВЬ (t) , from which it is obvious: ККр-Оп = (СОПУХОЛЬ(Т)) / (∫CКРОВЬ(t) dt), which was used in all calculations of the contrast transfer constant. Gadobutrol contrast is 0.1M/10 kg of body weight, TR = 5.5–6 ms, TE = 2.5 ms. Results. If, after the first cycle of NACHT, the ККр-Оп of the primary breast cancer is < 0.22 ml/min/g of tissue, the probability of subsequent relapse-free course = 0.78. Similarly, a decrease in the KCr-Op Ккр-Оп of the sentinel lymph node after the first cycle of NAHT < 0.08 ml/min/g of tissue with a probability of 0.75 predicts a relapse-free course. Conclusion. The proposed method for calculating the ККр-Оп transfer coefficient allows obtaining additional diagnostic and prognostic information in patients with local and locally advanced forms of breast cancer.
Keywords
About the Authors
W. Yu. UssovRussian Federation
Wladimir Yu. Ussov, Doctor of Medical Sciences, Professor, Chief Researcher of the Department of Radiation and Functional Research Methods
Rechkunovskaya str., 15, Novosibirsk, 630055
usov_v@meshalkin.ru
Competing Interests:
The authors declare no conflict of interest.
S. M. Minin
Russian Federation
Stanislav M. Minin, Candidate of Medical Sciences, Researcher of the Research Department of Oncology and Radiotherapy of the Institute of Oncology and Neurosurgery
Novosibirsk
Competing Interests:
The authors declare no conflict of interest.
N. A. Nikitin
Russian Federation
Nikita A. Nikitin, head of the X-ray department
Novosibirsk
Competing Interests:
The authors declare no conflict of interest.
E. N. Nogina
Russian Federation
Elena N. Nogina, Head of the Department of Drug and Antitumor Therapy at the Institute of Oncology and Neurosurgery
Novosibirsk
Competing Interests:
The authors declare no conflict of interest.
I. A. Kosarev
Russian Federation
Ilya A. Kosarev, oncologist-mammologist at the Institute of Oncology and Neurosurgery
Novosibirsk
Competing Interests:
The authors declare no conflict of interest.
E. Kobelev
Russian Federation
Evgeny Kobelev, Candidate of Medical Sciences, Junior Researcher at the Scientific Research Department of Radiation and Instrumental Research Methods
Novosibirsk
Competing Interests:
The authors declare no conflict of interest.
L. V. Bashkirov
Russian Federation
Leonid V. Bashkirov, is a junior researcher at the Scientific Research Department of Radiation and Instrumental Research Methods
Novosibirsk
Competing Interests:
The authors declare no conflict of interest.
Zh. Zh. Anashbaev
Russian Federation
Zhanat Zh. Anashbaev, radiologist of the Radiotherapy Department
Novosibirsk
Competing Interests:
The authors declare no conflict of interest.
N. A. Tarabanovskaya
Russian Federation
Natalia A. Tarabanovskaya, Candidate of Medical Sciences, Researcher, surgeon of the highest category of the Department of General Oncology
Tomsk
Competing Interests:
The authors declare no conflict of interest.
V. Yu. Babikov
Russian Federation
Viktor Yu. Babikov, is a postgraduate student at the E. D. Goldberg Research Institute of Pharmacology and Regenerative Medicine
Tomsk
Competing Interests:
The authors declare no conflict of interest.
Na. V. Denisova
Russian Federation
Natalia V. Denisova, Doctor of Physical and Mathematical Sciences, Professor, leading researcher
Novosibirsk
Competing Interests:
The authors declare no conflict of interest.
A. L. Chernyshova
Russian Federation
Alyona L. Chernyshova, Doctor of Medical Sciences, Professor of the Russian Academy of Sciences, Director of the Institute of Oncology and Neurosurgery
Novosibirsk
Competing Interests:
The authors declare no conflict of interest.
A. M. Chernyavsky
Russian Federation
Aleksandr M. Cherniavskii, Doctor of Medical Sciences, Professor, Corresponding Member of the Russian Academy of Sciences, General Director
Novosibirsk
Competing Interests:
The authors declare no conflict of interest.
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Review
For citations:
Ussov W.Yu., Minin S.M., Nikitin N.A., Nogina E.N., Kosarev I.A., Kobelev E., Bashkirov L.V., Anashbaev Zh.Zh., Tarabanovskaya N.A., Babikov V.Yu., Denisova N.V., Chernyshova A.L., Chernyavsky A.M. MR tomographic evaluation of the effectiveness of neoadjuvant chemotherapy for breast cancer based on pharmacokinetic numerical analysis of tumor uptake of paramagnetic contrast in intravenous contrast enhancement. Translational Medicine. 2024;11(5):428-444. (In Russ.) https://doi.org/10.18705/2311-4495-2024-11-5-428-444. EDN: ERFXXC