Early prediction of pathologic complete response of breast cancer after neoadjuvant chemotherapy using longitudinal ultrafast dynamic contrast-enhanced MRI

医学 乳腺癌 置信区间 接收机工作特性 曲线下面积 动态对比度 动态增强MRI 化疗 磁共振成像 核医学 乳房磁振造影 癌症 新辅助治疗 放射科 内科学 肿瘤科 乳腺摄影术
作者
Ying Cao,Xiaoxia Wang,Lan Li,Jinfang Shi,Xiangfei Zeng,Yao Huang,Huifang Chen,Fujie Jiang,Ting Yin,Dominik Nickel,Jiuquan Zhang
出处
期刊:Diagnostic and interventional imaging [Elsevier]
卷期号:104 (12): 605-614 被引量:6
标识
DOI:10.1016/j.diii.2023.07.003
摘要

The purpose of this study was to evaluate the temporal trends of ultrafast dynamic contrast-enhanced (DCE)-MRI during neoadjuvant chemotherapy (NAC) and to investigate whether the changes in DCE-MRI parameters could early predict pathologic complete response (pCR) of breast cancer.This longitudinal study prospectively recruited consecutive participants with breast cancer who underwent ultrafast DCE-MRI examinations before treatment and after two, four, and six NAC cycles between February 2021 and February 2022. Five ultrafast DCE-MRI parameters (maximum slope [MS], time-to-peak [TTP], time-to-enhancement [TTE], peak enhancement intensity [PEI], and initial area under the curve in 60 s [iAUC]) and tumor size were measured at each timepoint. The changes in parameters between each pair of adjacent timepoints were additionally measured and compared between the pCR and non-pCR groups. Longitudinal data were analyzed using generalized estimating equations. The performance for predicting pCR was assessed using area under the receiver operating characteristic curve (AUC).Sixty-seven women (mean age, 50 ± 8 [standard deviation] years; age range: 25-69 years) were included, 19 of whom achieved pCR. MS, PEI, iAUC, and tumor size decreased, while TTP increased during NAC (all P < 0.001). The AUC (0.92; 95% confidence interval [CI]: 0.83-0.97) of the model incorporating ultrafast DCE-MRI parameter change values (from timepoints 1 to 2) and clinicopathologic characteristics was greater than that of the clinical model (AUC, 0.79; 95% CI: 0.68-0.88) and ultrafast DCE-MRI parameter model at timepoint 2 when combined with clinicopathologic characteristics (AUC, 0.82; 95% CI: 0.71-0.90) (P = 0.01 and 0.02).Early changes in ultrafast DCE-MRI parameters after NAC combined with clinicopathologic characteristics could serve as predictive markers of pCR of breast cancer.
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