Abstract
BackgroundTo assess the performance of a predictive model of non-response to neoadjuvant chemotherapy (NAC) in patients with breast cancer based on texture, kinetic, and BI-RADS parameters measured from dynamic MRI.MethodsSixty-nine patients with invasive ductal carcinoma of the breast who underwent pre-treatment MRI were studied. Morphological parameters and biological markers were measured. Pathological complete response was defined as the absence of invasive and in situ cancer in breast and nodes. Pathological non-responders, partial and complete responders were identified. Dynamic imaging was performed at 1.5 T with a 3D axial T1W GRE fat-suppressed sequence. Visual texture, kinetic and BI-RADS parameters were measured in each lesion. ROC analysis and leave-one-out cross-validation were used to assess the performance of individual parameters, then the performance of multi-parametric models in predicting non-response to NAC.ResultsA model based on four pre-NAC parameters (inverse difference moment, GLN, LRHGE, wash-in) and k-means clustering as statistical classifier identified non-responders with 84 % sensitivity. BI-RADS mass/non-mass enhancement, biological markers and histological grade did not contribute significantly to the prediction.ConclusionPre-NAC texture and kinetic parameters help predicting non-benefit to NAC. Further testing including larger groups of patients with different tumor subtypes is needed to improve the generalization properties and validate the performance of the predictive model.
Highlights
To assess the performance of a predictive model of non-response to neoadjuvant chemotherapy (NAC) in patients with breast cancer based on texture, kinetic, and BI-RADS parameters measured from dynamic Magnetic Resonance Imaging (MRI)
Several trials comparing adjuvant chemotherapy and NAC demonstrated that long-term relapse-free and overall survival outcomes were the same [3]
NR were significantly less represented in Ki67 > 14 % and HR-/Human Epidermal growth factor Receptor 2 (HER2)+ compared to PR + CR
Summary
To assess the performance of a predictive model of non-response to neoadjuvant chemotherapy (NAC) in patients with breast cancer based on texture, kinetic, and BI-RADS parameters measured from dynamic MRI. Several trials comparing adjuvant chemotherapy and NAC demonstrated that long-term relapse-free and overall survival outcomes were the same [3]. The rate of response to NAC is limited and dependent on the subtypes of cancer [6,7,8,9,10,11,12]. It has been recently reported that pathological complete response (pCR) obtained after NAC is a suitable surrogate endpoint for disease-free survival in patients with luminal B/Human Epidermal growth factor Receptor 2 (HER2) -negative, HER2-positive (non-luminal) and triple negative tumors but not for those with luminal B/HER2-positive or luminal A tumors. The identification of non-responding patients is important, especially as it may allow considering alternative therapeutic options
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
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 callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
