Treatment Response Evaluation of Breast Cancer after Neoadjuvant Chemotherapy and Usefulness of the Imaging Parameters of MRI and PET/CT.
10.3346/jkms.2015.30.6.808
- Author:
Yeong Yi AN
1
;
Sung Hun KIM
;
Bong Joo KANG
;
Ah Won LEE
Author Information
1. Department of Radiology, College of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Neoadjuvant Chemotherapy;
Breast Neoplasm;
Pathologic Response;
Dynamic Contrast-enhanced MRI;
Diffusion-weighted MRI;
Positron Emission Tomography
- MeSH:
Adult;
Aged;
Antineoplastic Agents/*therapeutic use;
Breast Neoplasms/*diagnosis/*drug therapy;
Chemotherapy, Adjuvant/methods;
Female;
Humans;
Image Interpretation, Computer-Assisted/methods;
Magnetic Resonance Imaging/*methods;
Mammography/methods;
Middle Aged;
Multimodal Imaging/methods;
Neoadjuvant Therapy/methods;
Positron-Emission Tomography/*methods;
Reproducibility of Results;
Retrospective Studies;
Sensitivity and Specificity;
Tomography, X-Ray Computed/*methods;
Treatment Outcome
- From:Journal of Korean Medical Science
2015;30(6):808-815
- CountryRepublic of Korea
- Language:English
-
Abstract:
This study was aimed to evaluate the ability of imaging parameters measured on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), diffusion-weighted MRI (DWI) and positron emission tomography/computed tomography (PET/CT) to serve as response markers in breast cancer after neoadjuvant chemotherapy (NAC). In 20 patients with breast cancer, DCE-MRI and DWI using a 3 T scanner and PET/CT were performed before and after NAC. DCE-MRI was analyzed using an automatic computer-aided detection program (MR-CAD). The response imaging parameters were compared with the pathologic response. The areas under the curve (AUCs) for DCE-MRI using MR-CAD analysis, DWI and PET/CT were 0.77, 0.59 and 0.76, respectively. The combination of all parameters measured by MR-CAD showed the highest diagnostic performance and accuracy (AUC = 0.77, accuracy = 90%). The combined use of the parameters of PET/CT with DCE-MRI or DWI showed a trend toward improved specificity and negative predictive value (100%, 100%, accuracy = 87.5%). The use of DCE-MRI using MR-CAD parameters indicated better diagnostic performance in predicting the final pathological response compared with DWI and PET/CT, although no statistically significant difference was observed. The combined use of PET/CT with DCE-MRI or DWI may improve the specificity for predicting a pathological response.
