Magnetic resonance imaging of tumor response and cognitive impairment in breast cancer patients undergoing anthracycline-based systemic chemotherapy

Abstract

<p>Breast cancer is the most common cancer of women worldwide. The American Cancer Society estimated there were approximately 1.4 million new cases of invasive breast cancer worldwide in 2008. Anthracycline-based systemic chemotherapy is an important tool in the treatment of breast cancer, which is used to downstage the tumor before surgery and/or for palliative treatment in non-operable conditions. One common complaint of chemotherapy is a feeling of cognitive impairment, characterized by difficulty multitasking, difficulty keeping up with busy work environments, and an overall foggy mental feeling. Collectively, these effects are referred to as chemobrain. An active area of research is in the development of methods to predict response to chemotherapy, which could be used to tailor treatment and estimate prognosis with a greater degree of accuracy. Also, early subclinical detections of chemobrain could help to minimize side effects by modifying or changing the chemotherapy regimens. The purpose of the study is to evaluate the use of advanced MRI techniques to predict and monitor tumor response and to evaluate the changes in cognition in response to chemotherapy. Our experimental design will study 15 female adult breast cancer patients recruited from the Medical Oncology Hematology Associates group in Dayton, Ohio. Eligible subjects will receive thorough verbal and written informed consent-oriented explanations of the study. Each subject will undergo 4 non-invasive advanced magnetic resonance imaging sessions of the breast and brain using MR spectroscopy (MRS) and functional MRI (fMRI), respectively. Imaging sessions 1 and 4 will be accompanied by neuropsychological testing to assess the cognitive functions of the brain. We will recruit up to 15 normal control subjects to perform 2 imaging sessions accompanied by 2 neuropsychological tests 6 months apart. MRS will be evaluated as a predictor of treatment response by correlating baseline metabolite concentrations of the tumor with therapy outcome. Furthermore, the mechanisms of chemobrain will be investigated by correlating changes in fMRI activation over the treatment cycle with the results of the neuropsychological evaluations.</p><p>This presentation occurred at the Wright State University Campus-Wide Celebration of Research, Scholarship and Creative Activities on April 16, 2010</p>