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British Journal of Radiology (2006) 79, 308-314
© 2006 British Institute of Radiology
doi: 10.1259/bjr/23046051
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Influence of post-treatment delay on the evaluation of the response to focused ultrasound surgery of breast cancer by dynamic contrast enhanced MRI

A Khiat, PhD D Gianfelice, MD M Amara, MSc and Y Boulanger, PhD

Département de Radiologie, Hôpital Saint-Luc du CHUM, 1058 St-Denis, Montreal, Quebec, H2X 3J4 Canada


Figure 1
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  		Figure 1. Graph showing the percentage of residual tumour determined by histopathology following MRI-guided focused ultrasound surgery(MRIgFUS) for 26 breast tumours in 25 patients. A variable degree of success was achieved at various stages of development of the technique.

 

Figure 2
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  		Figure 2. Dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) signal intensity curves as a function of image number (6.0 s/image) at the maximally enhancing pixel for patient 19 (a) before, (b) immediately after and (c) 7 days after MRI-guided focused ultrasound surgery (MRIgFUS), and for patient 21 (d) before, (e) immediately after and (d) 3 days after MRIgFUS. The absence of signal enhancement in (c) is consistent with the absence of residual tumour and the progressive signal enhancement in (b), (e) and (f) is attributable to benign tissue phenomena occurring in the first few days following focused ultrasound ablation.

 

Figure 3
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  		Figure 3. Graphs showing the correlation between parameters calculated from the post-treatment dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) data and the percentage of residual viable cancer determined by histopathology on the excised mass for breast tumours treated by MRI-guided focused ultrasound surgery (MRIgFUS): increase in signal intensity (ISI) for (a) all patients (r = 0.749) and (b) patients who had their post-treatment evaluation at least 7 days after treatment (r = 0.962); positive enhancement integral (PEI) for (c) all patients (r = 0.778), and (d) patients who had their post-treatment evaluation at least 7 days after treatment (r = 0.934). Points corresponding to patients whose post-treatment was performed 3 days after MRIgFUS are shown as asterisks (*) in (a) and (c).

 

Figure 4
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  		Figure 4. Receiver operating characteristic curves for the increase in signal intensity(ISI) parameter calculated from the dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) data for (a) 26 tumours analysed 3–14 days after the MRI-guided focused ultrasound surgery (MRIgFUS) and (b) 20 tumours analysed 7–14 days after the MRIgFUS. The areas under the curves were (a) 0.853 and (b) 0.986 and the p-values for asymptotic significance were (a) 0.005 and (b) 0.001. A significant improvement is obtained when only data for patients examined 7 days or more after MRIgFUS are considered.

 




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