Project: 7 Tesla Magnetic Resonance Spectroscopy for optimal evaluation of response to neoadjuvant chemotherapy in breast cancer patients

7 Tesla Magnetic Resonance Spectroscopy for optimal evaluation of response to neoadjuvant chemotherapy in breast cancer patients

Dit is de samenvatting van de aanvraag.

Worldwide, breast cancer is the most frequently occurring cancer in women. Patients with locally advanced breast cancer are initially treated with neoadjuvant chemotherapy, followed by surgery and often radiotherapy. Nevertheless, the mortality of advanced breast cancers is high. Monitoring the efficacy of chemotherapy with sensitive biomarkers in an early stage may be used to switch treatment to different, more effective chemotherapeutics in non-responding patients. Currently Magnetic Resonance Imaging (MRI) is used to measure tumour volume shrinkage during chemotherapy prior to surgery as a biomarker of tumour response. However, changes in tumour volume occur in a relatively late phase of the therapy, and are therefore not optimal to guide treatment choices.

A more direct way to measure the effectiveness of therapy is to monitor metabolism related to cell proliferation. With phosphorus MR spectroscopy several compounds in cell proliferation can be detected non-invasively. Studies in animal models have shown strong correlation of these compounds (biomarkers) with the efficacy of chemotherapy. In patients however, this technique is severely hampered by its inherently low sensitivity.

However, MR technology can be improved to increase its sensitivity. First of all the strength of the magnet of the MR system has been increased to 7 Tesla and is available for human use in our centre. In addition, multiple detectors rather than single detectors can be implemented. Finally, sensitivity transformations can be used in the detection enhancement of metabolites involved in cell proliferation. In this study, I will maximize the gain in sensitivity by a novel combination of all these techniques. The detection limit of phosphorus MR spectroscopy biomarkers in locally advanced breast cancer will be investigated and the value of these biomarkers to predict the efficacy of neo-adjuvant chemotherapy will be explored.