| Project/Area Number |
17K10389
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Radiation science
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| Research Institution | Hokkaido University |
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Principal Investigator |
Kato Fumi 北海道大学, 大学病院, 助教 (80399865)
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| Co-Investigator(Kenkyū-buntansha) |
山下 啓子 北海道大学, 大学病院, 教授 (70332947)
ワン ジェフリー 北海道大学, 国際連携研究教育局, 博士研究員 (80754829)
馬場 基 独立行政法人国立病院機構北海道がんセンター(臨床研究部), 臨床研究部, 乳腺外科医師 (90724980)
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| Project Period (FY) |
2017-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥3,900,000 (Direct Cost: ¥3,000,000、Indirect Cost: ¥900,000)
Fiscal Year 2019: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2018: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2017: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
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| Keywords | 乳癌 / MRI / 術前化学療法 |
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| Outline of Final Research Achievements |
We analyzed breast MRI findings of breast cancer patients who had received neoadjuvant chemotherapy (NAC) to develop a model predicting treatment effect using MRI. Differences were seen in mass size, kinetic pattern in dynamic contrast enhanced image, ADC value of diffusion weighted image and K value of diffusion kurtosis image at midpoint of NAC between a pathological complete response (pCR) group and a non-pCR group. Differences were also seen in amount and/or rate of these changes between pre and midpoint NAC. K value of pre-NAC MRI of the pCR group was significantly higher than that of the non-pCR group in hormone receptor negative-HER2 positive breast cancers, which is the subtype having the highest pCR rate.
We also investigated the relationship between ADC value and axillary lymph node (LN) metastasis, which is an important prognostic factor in luminal A-like breast cancer. ADC values of breast lesions with positive LN were significantly lower than those with negative LN.
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| Academic Significance and Societal Importance of the Research Achievements |
乳癌の術前化学療法の治療効果を、MRIを用いて治療終了前に予測できれば、治療を継続するかどうかの判断を非侵襲的に行うことができる。さらに治療前に効果を予測することができれば、より適切な治療を選択可能となる。術前化学療法の効果は予後とも関連するため、治療効果の予測は予後の予測にも繋がる。
ルミナルA乳癌は最も予後良好なサブタイプであるため、術後や治療後の生活の質を保つことも重要である。MRIで非侵襲的にリンパ節転移がないことを術前に評価することにより、センチネルリンパ節生検も省略可能となり得るため、より侵襲度を低くすることが可能となる。
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