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Dynamic contrast-enhanced MRI for assessing and predicting the response of breast cancer to neoadjuvant chemotherapy(PDF)

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

Issue:
2019年第7期
Page:
794-799
Research Field:
医学影像物理
Publishing date:

Info

Title:
Dynamic contrast-enhanced MRI for assessing and predicting the response of breast cancer to neoadjuvant chemotherapy
Author(s):
LUO Yixian MAJie LIU Yongguang YI Chunyan XU Mei HUANG Shelei
Department of Radiology, Shenzhen People’s Hospital (the Second Clinical Medical College of Ji’nan University), Shenzhen 518109, China
Keywords:
Keywords: breast cancer neoadjuvant chemotherapy dynamic contrast-enhanced magnetic resonance imaging therapeutic effect
PACS:
R445.2;R737.9
DOI:
DOI:10.3969/j.issn.1005-202X.2019.07.010
Abstract:
Abstract: Objective To explore the value of dynamic contrast-enhanced MRI for assessing and predicting the therapeutic effects of neoadjuvant chemotherapy (NAC) for breast cancer. Methods A retrospective analysis was performed on the clinical data of 45 patients with invasive breast cancer confirmed by surgery and pathology who received NAC before surgery. According to therapeutic effect of NAC for breast cancer which was evaluated by the histopathological changes before and after chemotherapy, the patients were divided into pathologic complete response (pCR) group and non-pathologic complete response (NpCR) group. The dynamic contrast-enhanced MRI parameters in 2 groups were analyzed before and after chemotherapy. The pathological result was used as gold standard. Receiver operating characteristic curve (ROC) analysis was performed on the parameters with statistical significance, and the corresponding area under curve (AUC) was calculated to evaluate the effectiveness of the parameters in assessing the therapeutic effect of NAC. Based on the analyzed results, Logist Pmodel was established for predicting the therapeutic effect of NAC for breast cancer. Results Among the 45 cases, there were 16 in pCR group and 29 in NpCR group. Significant difference was found in tumor maximum meridian change rate (ΔD%), tumor volume change rate (ΔV%), change of early intensive degree (ΔS%), maximum linear slope change rate of time-intensity curve (ΔSmax%), changes of time-intensity curve type (ΔTIC) between pCR group and NpCR group (P<0.05). The AUC of ΔD%, ΔV%, ΔS%, ΔSmax% and ΔTIC were 0.711, 0.759, 0.711, 0.795 and 0.692, respectively, and the sensitivity/specificity were 0.38/0.97, 0.81/0.66, 0.56/0.83, 0.75/0.76 and 0.69/0.62, respectively. The AUC of Logit P model combining tumor volume change rate and maximum linear slope change rate of time-intensity curve for pathological prediction was 0.793 (95%CI 0.644-0.942). Conclusion The dynamic contrast-enhanced MRI parameters in the early stage can be used for assessing and predicting the response of breast cancer to NAC.

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Last Update: 2019-07-25