MRI Measurements of Breast Tumor Volume Predict Response to Neoadjuvant Chemotherapy and Recurrence-Free Survival

医学 化疗 单变量分析 磁共振成像 预测值 多元分析 试验预测值 新辅助治疗 乳腺癌 核医学 放射科 肿瘤科 内科学 癌症
作者
Savannah C. Partridge,Jessica Gibbs,Ying Lü,Laura J. Esserman,Debasish Tripathy,Dulcy Wolverton,Hope S. Rugo,E. Shelley Hwang,Cheryl A. Ewing,Nola M. Hylton
出处
期刊:American Journal of Roentgenology [American Roentgen Ray Society]
卷期号:184 (6): 1774-1781 被引量:251
标识
DOI:10.2214/ajr.184.6.01841774
摘要

The purpose of this study was to assess the value of MRI measurements of breast tumor size for predicting recurrence-free survival (RFS) in patients undergoing neoadjuvant (preoperative) chemotherapy and to compare the predictive value of MRI with that of established prognostic indicators.The study included 62 patients undergoing neoadjuvant chemotherapy. The longest diameter and volume of each tumor were measured on MRI before and after one and four cycles of treatment. Change in diameter on clinical examination, tumor size at pathology, and the number of positive nodes were determined. Each measure of tumor extent was assessed for the ability to predict RFS.Univariate Cox analysis showed initial MRI volume was the strongest predictor of RFS (p = 0.002). Final change in MRI volume (p = 0.015) was more predictive than change in diameter on MRI (p = 0.077) or clinical examination (p = 0.27). Initial diameter on MRI (p = 0.003) and clinical examination (p = 0.033), tumor size at pathology (p = 0.016), and number of positive nodes (p = 0.045) were also significantly predictive of RFS. Early change in MRI volume (p = 0.071) and diameter (p = 0.081) after one chemotherapy cycle showed trends of association with RFS. Multivariate analysis showed initial MRI volume (p = 0.005) and final change in MRI volume (p = 0.003) were significant independent predictors.MRI tumor volume was more predictive of RFS than tumor diameter, suggesting that volumetric changes measured using MRI may provide a more sensitive assessment of treatment efficacy.
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