Abstract
The purpose of this study was to investigate imaging parameters predicting pathologic complete response (pCR) in pretreatment dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) in breast cancer patients who were treated with neoadjuvant chemotherapy (NAC). A total of 74 patients who received NAC followed by surgery were retrospectively reviewed. All patients underwent breast MRI before NAC. Perfusion parameters including Ktrans, Kep and Ve of tumor were measured three-dimensionally. These perfusion parameters of background parenchyma of contralateral breasts were analyzed two-dimensionally. Receiver-operating characteristic (ROC) analysis and multivariable logistic regression analysis were performed to compare the ability of perfusion parameters to predict pCR. Of 74 patients, 13 achieved pCR in final pathology. The fiftieth percentile and skewness of each perfusion parameter – Ktrans, Kep, and Ve of tumor were associated with pCR. Perfusion parameters of contralateral breast parenchyma in 2D analysis also showed predictive ability for pCR. The model combining perfusion parameters of contralateral breast background parenchyma and those of the tumor had higher predictive value than each single parameter. Thus, perfusion parameters of tumor, background parenchyma of contralateral breast and their combinations in pretreatment breast MRI allow early prediction for pCR of breast cancer.
Highlights
Background parenchyma of contralateral beastarea under the curve (AUC) (99.8% CI**) 0.731 (0.485–0.978) 0.760 (0.549–0.972) 0.757 (0.543–0.970) 0.626 (0.329–0.922) 0.633 (0.339–0.927) 0.631 (0.336–0.925) 0.628 (0.328–0.928) 0.718 (0.495–0.940) 0.807 (0.563–1.000)with a combination of all three parameters of volume of tissue (Ve) showed a high odds ratio (OR) (5.26, 95% CI: 1.89–14.64, p = 0.002) (Table 6)
Thirteen (17.5%) of these 74 patients achieved pathologic complete response (pCR) based on specimens obtained from surgery after neoadjuvant chemotherapy (NAC)
In locally advanced breast cancer, NAC has been suggested as a means to improve prognosis
Summary
Perfusion parameters of BPCL were obtained by twodimensional (2D) analysis. Mean values of Ktrans, Kep, and Ve were derived. These parameters were measured by drawing a eliptical region of interest (ROI) at the level showing the largest fibroglandular tissue without enhancing lesions, except for the skin and fat layer (Fig. 3). Optimal cut-off values, sensitivities, and specificities of each parameter were obtained from the Youden index on the ROC curve. Parenchymal Enhancement on Preoperative Magnetic Resonance Imaging: Association With Recurrence-Free Survival in Breast Cancer Patients Treated With Neoadjuvant Chemotherapy. A. et al Background parenchymal signal enhancement ratio at preoperative MR imaging: association with subsequent local recurrence in patients with ductal carcinoma in situ after breast conservation surgery.
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call