Radiological Assessment of Response to Neoadjuvant Chemotherapy in Breast Cancer Females, Using Standard and Spectral Mammography

Steinhof-Radwańska, Katarzyna; Grażyńska, Anna; Lorek, Andrzej; Gutkowska, Anna Barczyk; Chrascina, Joanna Szczudlo; Bobola, Agnieszka; Okas, Karolina; Lelek, Zuzanna; Morawska, Irmina; Urbaś, Weronika; Gisterek, Iwona

doi:10.21203/rs.3.rs-217660/v1

Cited by 1 publication

(1 citation statement)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consistent with previous studies we have shown that CESM has greater accuracy at predicting pCR than mammography. 10,[15][16][17][18] With respect to DBT, our results are similar to two studies which compared DBT to mammography and ultrasound, reporting a sensitivity of 44.7-50% and specificity of 91-97.6%. 11,19 However this is the first study to consider the combined use of CESM and DBT in the context of NACT.…”

Section: Discussionsupporting

confidence: 88%

Predicting the response to Neoadjuvant Chemotherapy. Can the addition of tomosynthesis improve the accuracy of CESM? A comparison with breast MRI

Savaridas

Vinnicombe

Warwick

et al. 2022

Preprint

View full text Add to dashboard Cite

BackgroundNeoadjuvant chemotherapy (NACT) is used to downstage breast cancer prior to surgery. Image monitoring is essential to guide treatment and to assess in vivo chemosensitivity. Breast MRI is considered the gold-standard imaging technique; however, it is contraindicated or poorly tolerated in some patients and may be hard to access. Evidence suggests contrast enhanced spectral mammography (CESM) may approach the accuracy of MRI. This novel pilot study investigates whether the addition of digital breast tomosynthesis (DBT) to CESM increases the accuracy of response prediction.ResultsSixteen cancers in fourteen patients were imaged with CESM+DBT and MRI following completion of NACT. Ten cancers demonstrated pathological complete response (pCR) defined as absence of residual invasive disease. Greatest accuracy for predicting pCR was with CESM contrast-enhancement only (accuracy 81.3%, sensitivity 100%, specificity 57.1%), followed by MRI (accuracy 62.5%, sensitivity 44.4%, specificity 85.7%). Concordance with invasive tumour size was greater for CESM than MRI, concordance-coefficients 0.70 vs 0.66 respectively. MRI demonstrated greatest concordance with whole tumour size followed by CESM contrast-enhancement plus microcalcification, concordance-coefficients 0.86 vs 0.69. The addition of DBT did not improve accuracy for prediction of pCR or residual disease size. Whereas CESM+DBT tended to underestimate size of residual disease, MRI tended to overestimate but no significant differences were seen (p>0.05).ConclusionsCESM contrast-enhancement plus microcalcification is similar to MRI for predicting residual disease post-NACT. Size of enhancement alone demonstrates best concordance with invasive disease. Inclusion of residual microcalcification improves concordance with DCIS. The addition of DBT to CESM does not improve accuracy.HighlightsNo benefit of adding DBT to CESM for NACT response predictionCESM appears similar to MRI for predicting response to NACTCESM has greatest accuracy for residual invasive tumour size.CESM+calcification has greater accuracy for predicting residual in situ disease.

show abstract