Background parenchymal enhancement in breast MRI before and after neoadjuvant chemotherapy: correlation with tumour response

Preibsch, Heike; Wanner, Laura; Bahrs, SD; Wietek, Beate; Siegmann-Luz, K; Oberlecher, E.; Hahn, Markus; Staebler, Annette; Nikolaou, Konstantin; Wiesinger, Benjamin

doi:10.1007/s00330-015-4011-x

Cited by 67 publications

(73 citation statements)

References 26 publications

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“…7,8,17,25,39,[44][45][46]49 In particular, four studies 7,8,17,49 evaluated both intrareader and interreader agreements and the other five studies evaluated only interreader agreement. Kappa values for intrareader agreement were moderate to almost perfect, while more variability was The unenhanced images were not used.…”

Section: Resultsmentioning

confidence: 99%

“…8,10,[12][13][14][15]21,23,26,28,[32][33][34][35][36]38,[40][41][42][43][48][49][50][51][52][53][54]57,59,61 In five studies, 11,17,19,29,44 the authors acknowledged that owing to the retrospective nature of the study, it was not possible to analyze the point of menstrual cycle, although, following institutional protocol, screening breast MRI of patients who were pre-menopausal was performed during the second week of the menstrual cycle. In a total of 14 studies, the authors stated the menstrual period.…”

Section: Quantitative Background Parenchymal Enhancement Assessmentmentioning

confidence: 99%

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Evaluation of background parenchymal enhancement on breast MRI: a systematic review

Bignotti¹,

Signori²,

Valdora³

et al. 2017

The British Journal of Radiology

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Objective: To perform a systematic review of the methods used for background parenchymal enhancement (BPE) evaluation on breast MRI. Methods: Studies dealing with BPE assessment on breast MRI were retrieved from major medical libraries independently by four reviewers up to 6 October 2015. The keywords used for database searching are "background parenchymal enhancement", "parenchymal enhancement", "MRI" and "breast". The studies were included if qualitative and/or quantitative methods for BPE assessment were described. Results: Of the 420 studies identified, a total of 52 articles were included in the systematic review. 28 studies performed only a qualitative assessment of BPE, 13 studies performed only a quantitative assessment and 11 studies performed both qualitative and quantitative assessments. A wide heterogeneity was found in the MRI sequences and in the quantitative methods used for BPE assessment. Conclusion: A wide variability exists in the quantitative evaluation of BPE on breast MRI. More studies focused on a reliable and comparable method for quantitative BPE assessment are needed. Advances in knowledge: More studies focused on a quantitative BPE assessment are needed.

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Section: Resultsmentioning

confidence: 99%

Section: Quantitative Background Parenchymal Enhancement Assessmentmentioning

confidence: 99%

Evaluation of background parenchymal enhancement on breast MRI: a systematic review

Bignotti¹,

Signori²,

Valdora³

et al. 2017

The British Journal of Radiology

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“…BPE and FGT on MRI have been implicated as sensitive predictive and prognostic imaging biomarkers in breast cancer (12)(13)(14)(15)17,31). The investigation of BPU as another potential sensitive and also quantifiable imaging biomarker for breast cancer prediction, prognosis, and risk assessment is, therefore, of considerable interest.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, MRI provides insight about the amount of fibroglandular tissue (FGT), as well as background parenchymal enhancement (BPE). Thus, FGT and BPE are considered more sensitive predictive and prognostic imaging biomarkers than density assessment with mammography (12)(13)(14)(15)(16)(17)(18).…”

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confidence: 99%

Quantitative Assessment of Breast Parenchymal Uptake on ¹⁸F-FDG PET/CT: Correlation with Age, Background Parenchymal Enhancement, and Amount of Fibroglandular Tissue on MRI

et al. 2016

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Background parenchymal enhancement (BPE), and the amount of fibroglandular tissue (FGT) assessed with MRI have been implicated as sensitive imaging biomarkers for breast cancer. The purpose of this study was to quantitatively assess breast parenchymal uptake (BPU) on 18 F-FDG PET/CT as another valuable imaging biomarker and examine its correlation with BPE, FGT, and age. Methods: This study included 129 patients with suspected breast cancer and normal imaging findings in one breast (BI-RADS 1), whose cases were retrospectively analyzed. All patients underwent prone 18 F-FDG PET/CT and 3-T contrast-enhanced MRI of the breast. In all patients, interpreter 1 assessed BPU quantitatively using SUV max . Interpreters 1 and 2 assessed amount of FGT and BPE in the normal contralateral breast by subjective visual estimation, as recommended by BI-RADS. Interpreter 1 reassessed all cases and repeated the BPU measurements. Statistical tests were used to assess correlations between BPU, BPE, FGT, and age, as well as inter-and intrainterpreter agreement. Results: BPU on 18 F-FDG PET/CT varied among patients. The mean BPU SUV max ± SD was 1.57 ± 0.6 for patients with minimal BPE, 1.93 ± 0.6 for mild BPE, 2.42 ± 0.5 for moderate BPE, and 1.45 ± 0.3 for marked BPE. There were significant (P , 0.001) moderate to strong correlations among BPU, BPE, and FGT. BPU directly correlated with both BPE and FGT on MRI. Patient age showed a moderate to strong indirect correlation with all 3 imaging-derived tissue biomarkers. The coefficient of variation for quantitative BPU measurements with SUV max was 5.6%, indicating a high reproducibility. Interinterpreter and intrainterpreter agreement for BPE and FGT was almost perfect, with a κ-value of 0.860 and 0.822, respectively. Conclusion: The results of our study demonstrate that BPU varied among patients. BPU directly correlated with both BPE and FGT on MRI, and BPU measurements were highly reproducible. Patient age showed a strong inverse correlation with all 3 imaging-derived tissue biomarkers. These findings indicate that BPU may serve as a sensitive imaging biomarker for breast cancer prediction, prognosis, and risk assessment.

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“…This is a clear advantage of our methodology over competing approaches to bMRI assessment of TR to NAC (e.g. [16] reporting κ as low as 0.6).…”

Section: Discussionmentioning

confidence: 90%

Automated Semi-Quantitative Analysis of Breast MRI: Potential Imaging Biomarker for the Prediction of Tissue Response to Neoadjuvant Chemotherapy

et al. 2017

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Background: We aimed to investigate an automated semi-quantitative software as an imaging biomarker for the prediction of tissue response (TR) after completion of neoadjuvant chemotherapy (NAC). Methods: Breast magnetic resonance imaging (MRI) (1.5T, protocol according to international recommendations) of 67 patients with biopsy-proven invasive breast cancer were examined before and after NAC. After completion of NAC, histopathologic assessments of TR were classified according to the Chevallier grading system (CG1/4: full/non-responder; CG2/C3: partial responder). A commercially available fully automatic software (CADstream) extracted MRI parameters of tumor extension (tumor diameter/volume: TD/TV). Pre- versus post-NAC values were compared (ΔTV and ΔTD). Additionally, the software performed volumetric analyses of vascularization (VAV) after NAC. Accuracy of MRI parameters to predict TR were identified (cross-tabs, ROC, AUC, Kruskal-Wallis). Results: There were 37 (34.3%) CG1, 7 (6.5%) CG2, 53 (49.1%) CG3, and 11 (10.2%) CG4 lesions. The software reached area under the curve levels of 79.5% (CG1/complete response: ΔTD), 68.6% (CG2, CG3/partial response: VAV), and 88.8% to predict TR (CG4/non-response: ΔTV). Conclusion: Semi-quantitative automated analysis of breast MRI data enabled the prediction of tissue response to NAC.

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Background parenchymal enhancement in breast MRI before and after neoadjuvant chemotherapy: correlation with tumour response

Abstract: • BPE decreases by an average of 0.87 categories under neoadjuvant chemotherapy. • The reduction of BPE following neoadjuvant chemotherapy correlates with the tumour response. • The classification of the BPE shows good agreement among trained readers.

Cited by 67 publications

References 26 publications

Evaluation of background parenchymal enhancement on breast MRI: a systematic review

Evaluation of background parenchymal enhancement on breast MRI: a systematic review

Quantitative Assessment of Breast Parenchymal Uptake on ¹⁸F-FDG PET/CT: Correlation with Age, Background Parenchymal Enhancement, and Amount of Fibroglandular Tissue on MRI

Automated Semi-Quantitative Analysis of Breast MRI: Potential Imaging Biomarker for the Prediction of Tissue Response to Neoadjuvant Chemotherapy

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Background parenchymal enhancement in breast MRI before and after neoadjuvant chemotherapy: correlation with tumour response

Abstract: • BPE decreases by an average of 0.87 categories under neoadjuvant chemotherapy. • The reduction of BPE following neoadjuvant chemotherapy correlates with the tumour response. • The classification of the BPE shows good agreement among trained readers.

Cited by 67 publications

References 26 publications

Evaluation of background parenchymal enhancement on breast MRI: a systematic review

Evaluation of background parenchymal enhancement on breast MRI: a systematic review

Quantitative Assessment of Breast Parenchymal Uptake on 18F-FDG PET/CT: Correlation with Age, Background Parenchymal Enhancement, and Amount of Fibroglandular Tissue on MRI

Automated Semi-Quantitative Analysis of Breast MRI: Potential Imaging Biomarker for the Prediction of Tissue Response to Neoadjuvant Chemotherapy

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Quantitative Assessment of Breast Parenchymal Uptake on ¹⁸F-FDG PET/CT: Correlation with Age, Background Parenchymal Enhancement, and Amount of Fibroglandular Tissue on MRI