Microwave imaging for neoadjuvant chemotherapy monitoring: initial clinical experience

• Published in: Breast cancer research : BCR Vol. 15; no. 2; p. R35
• Main Authors: Meaney, Paul M, Kaufman, Peter A, Muffly, Lori S, Click, Michael, Poplack, Stephen P, Wells, Wendy A, Schwartz, Gary N, di Florio-Alexander, Roberta M, Tosteson, Tor D, Li, Zhongze, Geimer, Shireen D, Fanning, Margaret W, Zhou, Tian, Epstein, Neil R, Paulsen, Keith D
• Format: Journal Article
• Language: English
• Published: London BioMed Central 24.04.2013; BioMed Central Ltd
• Subjects: Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biomedical and Life Sciences; Biomedicine; Breast Neoplasms - drug therapy; Breast Neoplasms - pathology; Cancer; Cancer Research; Carcinoma, Ductal, Breast - drug therapy; Carcinoma, Ductal, Breast - secondary; Carcinoma, Lobular - drug therapy; Carcinoma, Lobular - secondary; Chemotherapy, Adjuvant; Female; Humans; Image Processing, Computer-Assisted; Longitudinal Studies; Measurement; Microwaves; Neoadjuvant Therapy; Neoplasm Invasiveness; Neoplasm Staging; Oncology; Pilot Projects; Prognosis; Radiation; Research Article; Surgical Oncology; Technology application; Tomography; Complete Responder; Contralateral Breast; Elevated Zone; Microwave Property; Fibroglandular Tissue
• ISSN: 1465-542X; 1465-5411; 1465-542X
• DOI: 10.1186/bcr3418

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.