Fusão da ressonância nuclear magnética e cintilografia mamária no carcinoma de mama localmente avançado. Análise da correlação entre os exames em pacientes submetidos à quimioterapia neoadjuvante
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Data
2012-03-29
Autores
Bailão Junior, Antonio [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O câncer de mama localmente avançado (CMLA) é uma realidade de países em desenvolvimento. A quimioterapia neoadjuvante (QTN) permite uma avaliação in vivo da resposta a droga quimioterápica além de elevar as taxas de tratamento conservador. Não existe exame que possa predizer com fidelidade os achados clínicos pré QTN e sua relação aos achados anatomo-patológicos após a QTN, sendo a ressonância nuclear magnética (RNM) o exame de melhor correlação. Faz-se necessário métodos de imagem que aprimorem estes achados, sendo que a cintilografia (CTG) mamária e sua fusão com a RNM não foi avaliada no CMLA. Avaliação da fusão de imagens RNM/CTG mamaria e a em relação ao exame físico pré QTN, e o exame anatomopatológico pós QTN na mensuração do maior diâmetro tumoral em pacientes com CMLA, submetidas a QTN. Estudo prospectivo controlado, não randomizado, realizado no período de julho de 2008 a dezembro de 2011 no Hospital de Câncer de Barretos, em pacientes portadoras de CMLA, estádio clínico III, histologia ductal e lobular. As pacientes foram submetidas a QTN no esquema AC-T (doxorubicina+ ciclofosfamida, e paclitaxel) sendo 4 ciclos de AC e 4 ciclos de T com intervalo de 21 dias para cada ciclo. Todas as pacientes realizaram RNM, CTG, Fusão da RNM/CTG mama, no pré e pós-operatório. Realizou-se correlação com o exame clínico (EF) do pré-operatório e com o exame anatomo-patológico (AP) do pós-operatório. Avaliou-se o maior diâmetro tumoral, sendo utilizado o índice de correlação interclasse, para comparação entre os diferentes métodos de avaliação. Foram avaliados 31 pacientes, sendo que 64,5 % delas reuniam se no grupo IIIA, 32,3% IIIB, e 3,2% eram IIIC. A correlação entre os exames para...
Locally advanced breast cancer (LABC) is a reality in developing countries. Neoadjuvant chemotherapy (NAC) enables in vivo assessment of the response to chemotherapy drug and also increases the rates of conservative treatment. There is no test which can reliably predict the clinical pre NAC and its relationship with anatomopathological findings after NAC, thus the magnetic resonance imaging (MRI) is the examination of best correlation. Imaging methods which enhance those findings are necessary. The scintimammography (SM) and its fusion with breast MRI was not evaluated in the LABC. The Evaluation of the fusion MRI/SM in relation to the physical examination (PE) pre NAC and the anatomopathological examination post NAC in the measurement of the largest tumor size in patients with LABC, submitted to neoadjuvant chemotherapy. A non-randomized prospective controlled study was conducted in the Barretos Cancer Hospital (BCH) from July 2008 to December 2011. The study was performed in patients with LABC, clinical staging III, ductal and lobular histology. The patients were submitted to NAC in Scheme AC-T (doxorubicin + cyclophosphamide, and paclitaxel), four cycles of AC and 4 cycles of T with an interval of 21 days after each cycle. All the patients were submitted to MRI, SM, Fusion of MRI / SM preoperatively and postoperatively. We conducted a correlation with the PE of the preoperative and with anatomopathological examination (AP) of the postoperative. We evaluated the largest tumor size by using the intraclass correlation coefficient in order to perform a comparison between the different assessment methods. We evaluated 31 patients, 64.5% of them in the group IIIA, 32.3% in the group IIIB and 3.2% in the group IIIC. The correlation between the tests for larger tumor size was assessed by intraclass... (Complete abstract click electronic access below)
Locally advanced breast cancer (LABC) is a reality in developing countries. Neoadjuvant chemotherapy (NAC) enables in vivo assessment of the response to chemotherapy drug and also increases the rates of conservative treatment. There is no test which can reliably predict the clinical pre NAC and its relationship with anatomopathological findings after NAC, thus the magnetic resonance imaging (MRI) is the examination of best correlation. Imaging methods which enhance those findings are necessary. The scintimammography (SM) and its fusion with breast MRI was not evaluated in the LABC. The Evaluation of the fusion MRI/SM in relation to the physical examination (PE) pre NAC and the anatomopathological examination post NAC in the measurement of the largest tumor size in patients with LABC, submitted to neoadjuvant chemotherapy. A non-randomized prospective controlled study was conducted in the Barretos Cancer Hospital (BCH) from July 2008 to December 2011. The study was performed in patients with LABC, clinical staging III, ductal and lobular histology. The patients were submitted to NAC in Scheme AC-T (doxorubicin + cyclophosphamide, and paclitaxel), four cycles of AC and 4 cycles of T with an interval of 21 days after each cycle. All the patients were submitted to MRI, SM, Fusion of MRI / SM preoperatively and postoperatively. We conducted a correlation with the PE of the preoperative and with anatomopathological examination (AP) of the postoperative. We evaluated the largest tumor size by using the intraclass correlation coefficient in order to perform a comparison between the different assessment methods. We evaluated 31 patients, 64.5% of them in the group IIIA, 32.3% in the group IIIB and 3.2% in the group IIIC. The correlation between the tests for larger tumor size was assessed by intraclass... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Mamas - Cancer, Ressonancia magnetica nuclear, Exploração dos radioisotopos, Quimioterapia
Como citar
BAILÃO JUNIOR, Antonio. Fusão da ressonância nuclear magnética e cintilografia mamária no carcinoma de mama localmente avançado. Análise da correlação entre os exames em pacientes submetidos à quimioterapia neoadjuvante. 2012. 101 f. Dissertacao (mestrado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2012.