臺灣博碩士論文加值系統

Patients who present with late stage disease, which is frequently locally advanced (LABC), will be treated initially with neoadjuvant chemotherapy to down-stage the disease, followed by surgery and post-operative therapies. Monitoring a patient’s response to neoadjuvant chemotherapy is usually undertaken by clinical examination, mammography and ultrasound. Unfortunately, there is a poor correlation between the histological appearances of the tumor and measurements obtained by physical examination, mammography or ultrasound. Techniques for magnetic resonance (MR) imaging of the breast have been evolving over the past decade. Now, it has been suggested that breast MRI is more accurate in the diagnosis of breast tumor. Furthermore, dynamic contrast-enhanced MRI (DCE-MRI) permits evaluation of tumor neovasculature, thereby allowing an assessment of the pathophysiological response to chemotherapy therapy, which occurs prior to any volume changes.
In this study, we would like to determine whether early changes of pharmacokinetic parameters during neoadjuvant treatment can predict final clinicopathologic response using dynamic contrast enhanced MR imaging.

Table of Contents

Abstract ……………………………………………………I
Table of Contents ………………………………………II
List of Figures …………………………………………IV
List of Tables ……………………………………………V
Chapter 1 INTRODUCTION………………………………… 1
1.1 Motivation ...………………………….....4
1.2 Overview of Project ……………………….5
Chapter 2 RESEARCH THEORY …………………………….6
2.1 Network of vessels …………………………………6
2.2 Abnormalities in tumor vessels network7
2.3 Pharmacokinetic analysis and physiological
modeling of DCE-MRI...................8
2.3.1 Measurement of enhancement kinetics.8
2.3.2 Analysis of enhancement kinetics 10
2.3.2.1 Pharmacokinetic two-compartment
model -Concepts for General
Compartment Models ……………11
Chapter 3 MATERIAL AND METHODS ……………………….13
3.1 Patients ……………………………………………….13
3.2 Study design ………………………………………….13
3.3 MRI Acquisition ………………………………………14
3.4 Interpretation of MRI ………………………………15
3.5 Statistical analysis…………………………………17
Chapter 4 RESULTS………………………………………….18
4.1 Response Categorization……………………18
4.2 Qualitative analysis ………………………18
4.3 Pretreatment and post two cycles of
treatment parameter data …............19
4.4 Parameters and tumor changes according to tumor
response …….................................21
Chapter 5 DISCUSSION …………………………………….26
Chapter 6 CONCLUSION …………………………………….29
6.1 Problems and Solution …………………….29
6.2 Further Work …………………………………30
REFERENCE ……………………………………………………31

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