Early Prediction of Response to Neoadjuvant Chemotherapy Using Dynamic Contrast-Enhanced MRI and Ultrasound in Breast Cancer.
10.3348/kjr.2018.19.4.682
- Author:
Yunju KIM
1
;
Sung Hun KIM
;
Byung Joo SONG
;
Bong Joo KANG
;
Kwang il YIM
;
Ahwon LEE
;
Yoonho NAM
Author Information
1. Department of Radiology, National Cancer Center, Goyang 10408, Korea.
- Publication Type:Original Article
- Keywords:
DCE-MRI;
K(trans);
CEUS;
Preoperative chemotherapy;
Quantitative analysis
- MeSH:
Breast Neoplasms*;
Breast*;
Drug Therapy*;
Female;
Follow-Up Studies;
Humans;
Magnetic Resonance Imaging*;
Prospective Studies;
ROC Curve;
Ultrasonography*
- From:Korean Journal of Radiology
2018;19(4):682-691
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To determine the diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and DCE ultrasound (DCE-US) for predicting response to neoadjuvant chemotherapy (NAC) in breast cancer patients. MATERIALS AND METHODS: This Institutional Review Board-approved prospective study was performed between 2014 and 2016. Thirty-nine women with breast cancer underwent DCE-US and DCE-MRI before the NAC, follow-up DCE-US after the first cycle of NAC, and follow-up DCE-MRI after the second cycle of NAC. DCE-MRI parameters (transfer constant [Ktrans], reverse constant [kep], and leakage space [Ve]) were assessed with histograms. From DCE-US, peak-enhancement, the area under the curve, wash-in rate, wash-out rate, time to peak, and rise time (RT) were obtained. After surgery, all the imaging parameters and their changes were compared with histopathologic response using the Miller-Payne Grading (MPG) system. Data from minor and good responders were compared using Wilcoxon rank sum test, chi-square test, or Fisher's exact test. Receiver operating characteristic curve analysis was used for assessing diagnostic performance to predict good response. RESULTS: Twelve patients (30.8%) showed a good response (MPG 4 or 5) and 27 (69.2%) showed a minor response (MPG 1–3). The mean, 25th, 50th, and 75th percentiles of Ktrans and Kep of post-NAC DCE-MRI differed between the two groups. These parameters showed fair to good diagnostic performance for the prediction of response to NAC (AUC 0.76–0.81, p ≤ 0.007). Among DCE-US parameters, the percentage change in RT showed fair prediction (AUC 0.71, p = 0.023). CONCLUSION: Quantitative analysis of DCE-MRI and DCE-US was helpful for early prediction of response to NAC.
