Value of diffusion-weighted MRI in predicting early response to neoadjuvant chemotherapy of breast cancer: comparison between ROI-ADC and whole-lesion-ADC measurements

Hottat, Nathalie; Badr, Dominique A.; Lecomte, Sophie; Besse‐Hammer, Tatiana; Jani, Jacques; Cannie, Mieke

doi:10.1007/s00330-021-08462-z

Cited by 12 publications

(9 citation statements)

References 30 publications

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“…Study design and patient selection. This was an analysis of a prospective single-center study conducted between January 2016 and December 2019 on women with invasive breast cancer 15 . This study was approved by the institution's ethics committee of University Hospital Brugmann (EC 2016/76 B077201628620/I/U) and was also registered at ClinicalTrials.gov (NCT02798484, 14/06/2016).…”

Section: Methodsmentioning

confidence: 99%

“…A recent study demonstrated that a significant increase in the breast tumor region of interest (ROI) ADC on DWI predicts complete pCR and radiologic responses after one cycle of NACT. The two-dimensional (2D) ROI-ADC measurement of a tumoral target component was accurate and superior to the three-dimensional (3D) whole-lesion-ADC histogram analysis obtained after segmentation of the whole tumor 15 .…”

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confidence: 97%

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Assessment of diffusion-weighted MRI in predicting response to neoadjuvant chemotherapy in breast cancer patients

Hottat

Badr

Lecomte

et al. 2023

Sci Rep

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To compare region of interest (ROI)-apparent diffusion coefficient (ADC) on diffusion-weighted imaging (DWI) measurements and Ki-67 proliferation index before and after neoadjuvant chemotherapy (NACT) for breast cancer. 55 women were enrolled in this prospective single-center study, with a final population of 47 women (49 cases of invasive breast cancer). ROI-ADC measurements were obtained on MRI before and after NACT and were compared to histological findings, including the Ki-67 index in the whole study population and in subgroups of “pathologic complete response” (pCR) and non-pCR. Nineteen percent of women experienced pCR. There was a significant inverse correlation between Ki-67 index and ROI-ADC before NACT (r = − 0.443, p = 0.001) and after NACT (r = − 0.614, p < 0.001). The mean Ki-67 index decreased from 45.8% before NACT to 18.0% after NACT (p < 0.001), whereas the mean ROI-ADC increased from 0.883 × 10–3 mm2/s before NACT to 1.533 × 10–3 mm2/s after NACT (p < 0.001). The model for the prediction of Ki67 index variations included patient age, hormonal receptor status, human epidermal growth factor receptor 2 status, Scarff-Bloom-Richardson grade 2, and ROI-ADC variations (p = 0.006). After NACT, a significant increase in breast cancer ROI-ADC on diffusion-weighted imaging was observed and a significant decrease in the Ki-67 index was predicted. Clinical trial registration number: clinicaltrial.gov NCT02798484, date: 14/06/2016.

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Section: Methodsmentioning

confidence: 99%

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confidence: 97%

Assessment of diffusion-weighted MRI in predicting response to neoadjuvant chemotherapy in breast cancer patients

Hottat

Badr

Lecomte

et al. 2023

Sci Rep

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“…In recent years, MRI, positron emission tomography/computed tomography (PET/CT) and ultrasound have been investigated to evaluate tumor response to chemotherapy by depicting the changes in tumor size, metabolic activity or the blood perfusion [4][5][6][7]. MRI has been considered to be the standard method for assessing NAC response in patients with breast cancer [8][9].…”

Section: Introductionmentioning

confidence: 99%

Multiparametric contrast-enhanced ultrasound in early prediction of response to neoadjuvant chemotherapy and recurrence-free survival in breast cancer

Wan

Zhou

Liu

et al. 2023

Preprint

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Background Contrast-enhanced ultrasound (CEUS) is a promising tool and can facilitate dynamic observation and quantification of tumor perfusion without exposing the patients to any risk of radiation. This preliminary study aimed to investigate the value of CEUS in early predicting pCR and RFS in locally advanced breast cancer (LABC) patients receiving neoadjuvant chemotherapy (NAC). Methods In this retrospective interpretation of prospective data study, consecutive women with LABC who underwent CEUS examination pre-NAC and after one or two cycles of NAC from March 2014 to October 2018 were included. Written informed consent was obtained from all patients. CEUS qualitative parameters before NAC and quantitative parameters (peak intensity, PEAK; time to peak, TTP; regional blood volume, RBV; regional blood flow, RBF, and mean transit time, MTT) during NAC and their changes were assessed. The relative changes in CEUS parameters and tumor diameter after one and two cycles of NAC were describe as ΔA1 and ΔA2, respectively. Multivariate logistic regression analysis was performed to identify independent variables associated with pCR. Cox proportional hazards model and Kaplan-Meier analysis were used to investigate the independent variables of CEUS and clinical-pathologic factors with RFS. Results Among 122 patients (mean age, 51years), 44 (36.1%) underwent PCR. Logistic regression analysis showed that molecular subtype, PEAK1 and △diameter1 were the best predictors of pCR after one cycle of NAC (area under the receiver operating characteristic curve [AUC], 0.81; 95%CI: 0.73, 0.88); Molecular subtype, PEAK2 and △TTP2 were independently associated with pCR after two cycles of NAC (AUC, 0.85, 95% CI: 0.77, 0.91). After 63 months of median follow-up, there were 17 recurrences. Multivariable Cox proportional hazards analysis revealed that a higher clinical T (hazard ratio [HR] = 4.75; 95% CI: 1.75, 12.87; P = 0.002) and N stages (HR = 3.39; 95% CI: 1.25, 9.19; P = 0.02), and a longer TTP (HR = 1.06; 95% CI: 1.01,1.11; P = 0.02) at pre-NAC CEUS were independently associated with poorer RFS. Conclusions CEUS can be used as a noninvasively functional technique to early predict pCR as well as RFS in breast cancer patients treated with NAC.

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“…The apparent diffusion coefficient (ADC) is a quantitative measure derived from at least two DWI images with different b-values. Many breast DWI studies have shown that tumor ADC can provide valuable information for evaluating tumor response in the NAC setting [ 1 , 2 , 3 , 4 ], and can provide distinct information from quantitative measurements provided by dynamic contrast-enhanced (DCE) MRI. Compared to DCE-MRI, breast DWI often has poorer image quality due to artifacts and lower spatial resolution, and lacks standardization in image acquisition, image interpretation, and ADC calculation [ 5 ], factors that limit its widespread use in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Effect of Inter-Reader Variability on Diffusion-Weighted MRI Apparent Diffusion Coefficient Measurements and Prediction of Pathologic Complete Response for Breast Cancer

Onishi

et al. 2022

Tomography

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This study evaluated the inter-reader agreement of tumor apparent diffusion coefficient (ADC) measurements performed on breast diffusion-weighted imaging (DWI) for assessing treatment response in a multi-center clinical trial of neoadjuvant chemotherapy (NAC) for breast cancer. DWIs from 103 breast cancer patients (mean age: 46 ± 11 years) acquired at baseline and after 3 weeks of treatment were evaluated independently by two readers. Three types of tumor regions of interests (ROIs) were delineated: multiple-slice restricted, single-slice restricted and single-slice tumor ROIs. Compared to tumor ROIs, restricted ROIs were limited to low ADC areas of enhancing tumor only. We found excellent agreement (intraclass correlation coefficient [ICC] ranged from 0.94 to 0.98) for mean ADC. Higher ICCs were observed in multiple-slice restricted ROIs (range: 0.97 to 0.98) than in other two ROI types (both in the range of 0.94 to 0.98). Among the three ROI types, the highest area under the receiver operating characteristic curves (AUCs) were observed for mean ADC of multiple-slice restricted ROIs (0.65, 95% confidence interval [CI]: 0.52–0.79 and 0.67, 95% CI: 0.53–0.81 for Reader 1 and Reader 2, respectively). In conclusion, mean ADC values of multiple-slice restricted ROI showed excellent agreement and similar predictive performance for pathologic complete response between the two readers.

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Value of diffusion-weighted MRI in predicting early response to neoadjuvant chemotherapy of breast cancer: comparison between ROI-ADC and whole-lesion-ADC measurements

Cited by 12 publications

References 30 publications

Assessment of diffusion-weighted MRI in predicting response to neoadjuvant chemotherapy in breast cancer patients

Assessment of diffusion-weighted MRI in predicting response to neoadjuvant chemotherapy in breast cancer patients

Multiparametric contrast-enhanced ultrasound in early prediction of response to neoadjuvant chemotherapy and recurrence-free survival in breast cancer

Effect of Inter-Reader Variability on Diffusion-Weighted MRI Apparent Diffusion Coefficient Measurements and Prediction of Pathologic Complete Response for Breast Cancer

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