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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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| Published in: | European radiology 2018-07, Vol.28 (7), p.2986-2995 |
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| container_title | European radiology |
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| creator | 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 |
| description | 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 |
| doi_str_mv | 10.1007/s00330-017-5251-8 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1993006835</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1993520731</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-3b64586f0163d209638980ea92145c13c198256adb6aa2a9118c004f54b12eef3</originalsourceid><addsrcrecordid>eNp1kd2KFDEQhRtR3NnVB_BGAt54E60k_RfvZFB3YUUQvW7S6eqfsTtpk7QwT-krWcOMIoJXFVLfOZXUybJnAl4JgOp1BFAKOIiKF7IQvH6Q7USuJBdQ5w-zHWhV80rr_Cq7jvEAAFrk1ePsSlLjpN1lP_fepWBi4uhG4yx27OPnO2b6hIE59KY7bD-MS8yOuPg0YjDrkfmetQFJxexJE96wGePkHU-et8Z-G4LfXMdWE9DZ8biYmcVpcFQuUxYky2DS5FnvA-umaMO0TI5u3EC6NPrZD5MlhfXLOmNCFjCu3kVkffALI3g6-dLt1G10SNvit_Ake9SbOeLTS73Jvr5_92V_y-8_fbjbv73nVlUycdWWeVGXPYhSdRJ0qWpdAxotRV5YoazQtSxK07WlMdJoIWoLkPdF3gqJ2Kub7OXZdw3--4YxNQv9AefZ0NK22AitFUBZq4LQF_-gB3ooLeNMFRIqJYgSZ8oGH2PAvllpIyYcGwHNKe3mnHZDaTentJuaNM8vzlu7YPdH8TteAuQZiNRyA4a_Rv_X9RdAW7oG</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1993520731</pqid></control><display><type>article</type><title>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</title><source>Springer Link</source><creator>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</creator><creatorcontrib>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</creatorcontrib><description>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
<.001) in identifying pCR. SER ≤1.6 and/or size ≤0.2 cm criterion showed the highest specificity of 90.4%.
Conclusion
SER on early-phase MR images was independently associated with pCR, and showed improved AUC and specificity compared to the conventional criterion. The combined criterion of SER and size could be used to select candidates to avoid surgery in a future study.
Key points
•
Compared with conventional criterion, SER ≤ 1.6 criterion increased AUC and specificity.
•
Simple measurement of signal intensity could differentiate pCR from minimal residual cancer.
•
SER ≤1.6 and/or size≤0.2cm criterion showed the highest specificity of 90.4 %.
•
The combined criterion could be used for a study to avoid surgery.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-017-5251-8</identifier><identifier>PMID: 29380033</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>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</subject><ispartof>European radiology, 2018-07, Vol.28 (7), p.2986-2995</ispartof><rights>European Society of Radiology 2018</rights><rights>European Radiology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-3b64586f0163d209638980ea92145c13c198256adb6aa2a9118c004f54b12eef3</citedby><cites>FETCH-LOGICAL-c372t-3b64586f0163d209638980ea92145c13c198256adb6aa2a9118c004f54b12eef3</cites><orcidid>0000-0003-4290-2777</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29380033$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Soo-Yeon</creatorcontrib><creatorcontrib>Cho, Nariya</creatorcontrib><creatorcontrib>Shin, Sung Ui</creatorcontrib><creatorcontrib>Lee, Han-Byoel</creatorcontrib><creatorcontrib>Han, Wonshik</creatorcontrib><creatorcontrib>Park, In Ae</creatorcontrib><creatorcontrib>Kwon, Bo Ra</creatorcontrib><creatorcontrib>Kim, Soo Yeon</creatorcontrib><creatorcontrib>Lee, Su Hyun</creatorcontrib><creatorcontrib>Chang, Jung Min</creatorcontrib><creatorcontrib>Moon, Woo Kyung</creatorcontrib><title>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</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>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
<.001) in identifying pCR. SER ≤1.6 and/or size ≤0.2 cm criterion showed the highest specificity of 90.4%.
Conclusion
SER on early-phase MR images was independently associated with pCR, and showed improved AUC and specificity compared to the conventional criterion. The combined criterion of SER and size could be used to select candidates to avoid surgery in a future study.
Key points
•
Compared with conventional criterion, SER ≤ 1.6 criterion increased AUC and specificity.
•
Simple measurement of signal intensity could differentiate pCR from minimal residual cancer.
•
SER ≤1.6 and/or size≤0.2cm criterion showed the highest specificity of 90.4 %.
•
The combined criterion could be used for a study to avoid surgery.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Biopsy</subject><subject>Breast</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - diagnostic imaging</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Breast Neoplasms - pathology</subject><subject>Cancer</subject><subject>Chemotherapy</subject><subject>Chemotherapy, Adjuvant - methods</subject><subject>Contrast Media</subject><subject>Criteria</subject><subject>Diagnostic Radiology</subject><subject>Female</subject><subject>Histopathology</subject><subject>Humans</subject><subject>Image Enhancement - methods</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoadjuvant Therapy - methods</subject><subject>Neoplasm Staging</subject><subject>Neoplasm, Residual</subject><subject>Neuroradiology</subject><subject>Observer Variation</subject><subject>Radiology</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><subject>Surgery</subject><subject>Tumors</subject><subject>Ultrasound</subject><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kd2KFDEQhRtR3NnVB_BGAt54E60k_RfvZFB3YUUQvW7S6eqfsTtpk7QwT-krWcOMIoJXFVLfOZXUybJnAl4JgOp1BFAKOIiKF7IQvH6Q7USuJBdQ5w-zHWhV80rr_Cq7jvEAAFrk1ePsSlLjpN1lP_fepWBi4uhG4yx27OPnO2b6hIE59KY7bD-MS8yOuPg0YjDrkfmetQFJxexJE96wGePkHU-et8Z-G4LfXMdWE9DZ8biYmcVpcFQuUxYky2DS5FnvA-umaMO0TI5u3EC6NPrZD5MlhfXLOmNCFjCu3kVkffALI3g6-dLt1G10SNvit_Ake9SbOeLTS73Jvr5_92V_y-8_fbjbv73nVlUycdWWeVGXPYhSdRJ0qWpdAxotRV5YoazQtSxK07WlMdJoIWoLkPdF3gqJ2Kub7OXZdw3--4YxNQv9AefZ0NK22AitFUBZq4LQF_-gB3ooLeNMFRIqJYgSZ8oGH2PAvllpIyYcGwHNKe3mnHZDaTentJuaNM8vzlu7YPdH8TteAuQZiNRyA4a_Rv_X9RdAW7oG</recordid><startdate>20180701</startdate><enddate>20180701</enddate><creator>Kim, Soo-Yeon</creator><creator>Cho, Nariya</creator><creator>Shin, Sung Ui</creator><creator>Lee, Han-Byoel</creator><creator>Han, Wonshik</creator><creator>Park, In Ae</creator><creator>Kwon, Bo Ra</creator><creator>Kim, Soo Yeon</creator><creator>Lee, Su Hyun</creator><creator>Chang, Jung Min</creator><creator>Moon, Woo Kyung</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4290-2777</orcidid></search><sort><creationdate>20180701</creationdate><title>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</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-3b64586f0163d209638980ea92145c13c198256adb6aa2a9118c004f54b12eef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Biopsy</topic><topic>Breast</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - diagnostic imaging</topic><topic>Breast Neoplasms - drug therapy</topic><topic>Breast Neoplasms - pathology</topic><topic>Cancer</topic><topic>Chemotherapy</topic><topic>Chemotherapy, Adjuvant - methods</topic><topic>Contrast Media</topic><topic>Criteria</topic><topic>Diagnostic Radiology</topic><topic>Female</topic><topic>Histopathology</topic><topic>Humans</topic><topic>Image Enhancement - methods</topic><topic>Imaging</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoadjuvant Therapy - methods</topic><topic>Neoplasm Staging</topic><topic>Neoplasm, Residual</topic><topic>Neuroradiology</topic><topic>Observer Variation</topic><topic>Radiology</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>ROC Curve</topic><topic>Sensitivity and Specificity</topic><topic>Surgery</topic><topic>Tumors</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Soo-Yeon</creatorcontrib><creatorcontrib>Cho, Nariya</creatorcontrib><creatorcontrib>Shin, Sung Ui</creatorcontrib><creatorcontrib>Lee, Han-Byoel</creatorcontrib><creatorcontrib>Han, Wonshik</creatorcontrib><creatorcontrib>Park, In Ae</creatorcontrib><creatorcontrib>Kwon, Bo Ra</creatorcontrib><creatorcontrib>Kim, Soo Yeon</creatorcontrib><creatorcontrib>Lee, Su Hyun</creatorcontrib><creatorcontrib>Chang, Jung Min</creatorcontrib><creatorcontrib>Moon, Woo Kyung</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database (ProQuest)</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies & Aerospace Database (1962 - 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Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Soo-Yeon</au><au>Cho, Nariya</au><au>Shin, Sung Ui</au><au>Lee, Han-Byoel</au><au>Han, Wonshik</au><au>Park, In Ae</au><au>Kwon, Bo Ra</au><au>Kim, Soo Yeon</au><au>Lee, Su Hyun</au><au>Chang, Jung Min</au><au>Moon, Woo Kyung</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2018-07-01</date><risdate>2018</risdate><volume>28</volume><issue>7</issue><spage>2986</spage><epage>2995</epage><pages>2986-2995</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>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
<.001) in identifying pCR. SER ≤1.6 and/or size ≤0.2 cm criterion showed the highest specificity of 90.4%.
Conclusion
SER on early-phase MR images was independently associated with pCR, and showed improved AUC and specificity compared to the conventional criterion. The combined criterion of SER and size could be used to select candidates to avoid surgery in a future study.
Key points
•
Compared with conventional criterion, SER ≤ 1.6 criterion increased AUC and specificity.
•
Simple measurement of signal intensity could differentiate pCR from minimal residual cancer.
•
SER ≤1.6 and/or size≤0.2cm criterion showed the highest specificity of 90.4 %.
•
The combined criterion could be used for a study to avoid surgery.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>29380033</pmid><doi>10.1007/s00330-017-5251-8</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-4290-2777</orcidid></addata></record> |
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| language | eng |
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| 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 |
| title | 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 |
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