Contrast-enhanced MRI after neoadjuvant chemotherapy of breast cancer: lesion-to-background parenchymal signal enhancement ratio for discriminating pathological complete response from minimal residual tumour

Objectives To retrospectively investigate whether the lesion-to-background parenchymal signal enhancement ratio (SER) on breast MRI can distinguish pathological complete response (pCR) from minimal residual cancer following neoadjuvant chemotherapy (NAT), and compare its performance with the convent...

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Bibliographic Details
Published in:European radiology 2018-07, Vol.28 (7), p.2986-2995
Main Authors: Kim, Soo-Yeon, Cho, Nariya, Shin, Sung Ui, Lee, Han-Byoel, Han, Wonshik, Park, In Ae, Kwon, Bo Ra, Kim, Soo Yeon, Lee, Su Hyun, Chang, Jung Min, Moon, Woo Kyung
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biopsy
Breast
Breast cancer
Breast Neoplasms - diagnostic imaging
Breast Neoplasms - drug therapy
Breast Neoplasms - pathology
Cancer
Chemotherapy
Chemotherapy, Adjuvant - methods
Contrast Media
Criteria
Diagnostic Radiology
Female
Histopathology
Humans
Image Enhancement - methods
Imaging
Internal Medicine
Interventional Radiology
Magnetic resonance imaging
Magnetic Resonance Imaging - methods
Medicine
Medicine & Public Health
Middle Aged
Neoadjuvant Therapy - methods
Neoplasm Staging
Neoplasm, Residual
Neuroradiology
Observer Variation
Radiology
Regression analysis
Retrospective Studies
ROC Curve
Sensitivity and Specificity
Surgery
Tumors
Ultrasound
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Summary:Objectives To retrospectively investigate whether the lesion-to-background parenchymal signal enhancement ratio (SER) on breast MRI can distinguish pathological complete response (pCR) from minimal residual cancer following neoadjuvant chemotherapy (NAT), and compare its performance with the conventional criterion. Methods 216 breast cancer patients who had undergone NAT and MRI and achieved pCR or minimal residual cancer on surgical histopathology were included. Clinical-pathological features, SER and lesion size on MR images were analysed. Multivariate logistic regression, ROC curve and McNemar’s test were performed. Results SER on early-phase MR images was independently associated with pCR (odds ratio [OR], 0.286 [95% CI: 0.113–0.725], p = .008 for Reader 1; OR, 0.306 [95% CI: 0.111–0.841], p = .022 for Reader 2). Compared with the conventional criterion, SER ≤1.6 increased AUC (0.585–0.599 vs. 0.709–0.771, p =.001-.033) and specificity (21.9–27.4% vs. 80.8–86.3%, p
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-017-5251-8