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Open Access Highly Accessed Research article

Microwave imaging for neoadjuvant chemotherapy monitoring: initial clinical experience

Paul M Meaney1*, Peter A Kaufman2, Lori S Muffly2, Michael Click3, Stephen P Poplack3, Wendy A Wells4, Gary N Schwartz2, Roberta M di Florio-Alexander3, Tor D Tosteson5, Zhongze Li5, Shireen D Geimer6, Margaret W Fanning7, Tian Zhou8, Neil R Epstein1 and Keith D Paulsen1

Author Affiliations

1 Thayer School of Engineering, Dartmouth College, 14 Engineering Dr., Hanover, NH 03755, USA

2 Oncology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr., Lebanon, NH 03756, USA

3 Radiology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr., Lebanon, NH 03756, USA

4 Pathology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr., Lebanon, NH 03756, USA

5 Biostatistics Shared Resource, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr., Lebanon, NH 03756, USA

6 Radiology, Geisel School of Medicine, Dartmouth College, 74 College St., Hanover, NH 03755, USA

7 60 Cobb Hill Rd., Hartland, VT 05048, USA

8 Engineering, Kuang-Chi Institute of Advanced Technology, 29 Nanhuan Rd., Shenzhen, Guangdong, 518057, China

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Breast Cancer Research 2013, 15:R35  doi:10.1186/bcr3418

Published: 24 April 2013

Abstract

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.