Impact of Alternate b-Value Combinations and Metrics on the Predictive Performance and Repeatability of Diffusion-Weighted MRI in Breast Cancer Treatment: Results from the ECOG-ACRIN A6698 Trial.
Impact of Alternate b-Value Combinations and Metrics on the Predictive Performance and Repeatability of Diffusion-Weighted MRI in Breast Cancer Treatment: Results from the ECOG-ACRIN A6698 Trial.
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DOI：
10.3390/tomography8020058
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发表时间：
2022-03-04
期刊：
影响因子：
--
通讯作者：
Hylton NM
中科院分区：
文献类型：
--
作者：
Partridge SC;Steingrimsson J;Newitt DC;Gibbs JE;Marques HS;Bolan PJ;Boss MA;Chenevert TL;Rosen MA;Hylton NM
在弥散加权 MRI (DW-MRI) 中，b 值的选择通过探测组织微环境的不同方面来影响表观弥散系数 (ADC) 值。作为多中心 ECOG-ACRIN A6698 试验的二次分析，本研究的目的是调查替代 b 值组合对肿瘤 ADC 作为乳腺癌治疗反应预测标志物的性能和可重复性的影响。最终分析包括 210 名在新辅助化疗治疗期间的多个时间点接受标准化 4-b 值 DW-MRI (b = 0/100/600/800 s/mm2) 的女性以及接受重测扫描的子集 (n = 71)。使用可变 b 值组合进行集中肿瘤 ADC 和灌注分数 (fp) 测量。根据每个指标的治疗中期/12 周百分比变化来预测病理完全缓解 (pCR)，并通过受试者工作特征曲线 (AUC) 下的面积来估计。重复性通过受试者内变异系数（wCV）来估计。结果显示，总体而言，二 b 值 ADC 计算提供的预测值不劣于四 b 值 ADC 计算（AUC = 0.60–0.61 对比 AUC = 0.60），对于 ADC 最具预测性的 HR+/HER2− 癌症（AUC = 0.75–0.78 对比 AUC = 0.76），p < 0.05。与四个 b 值计算相比，使用两个 b 值（0/600 或 0/800 s/mm2）不会降低 ADC 的重复性（wCV = 4.9–5.2% 与 5.4%）。替代指标 ADCfast (b ≤ 100 s/mm2)、ADCslow (b ≥ 100 s/mm2) 和 fp 并未改善预测性能（AUC = 0.54–0.60，p = 0.08–0.81），并且 ADCfast 和 fp 表现出最低的重复性（wCV 分别 = 6.71% 和 12.4%）。总之，使用简单的二 b 值方法计算的乳腺肿瘤 ADC 可以提供与作为治疗反应标志的完整四 b 值测量相当的预测值和重复性。
In diffusion-weighted MRI (DW-MRI), choice of b-value influences apparent diffusion coefficient (ADC) values by probing different aspects of the tissue microenvironment. As a secondary analysis of the multicenter ECOG-ACRIN A6698 trial, the purpose of this study was to investigate the impact of alternate b-value combinations on the performance and repeatability of tumor ADC as a predictive marker of breast cancer treatment response. The final analysis included 210 women who underwent standardized 4-b-value DW-MRI (b = 0/100/600/800 s/mm2) at multiple timepoints during neoadjuvant chemotherapy treatment and a subset (n = 71) who underwent test–retest scans. Centralized tumor ADC and perfusion fraction (fp) measures were performed using variable b-value combinations. Prediction of pathologic complete response (pCR) based on the mid-treatment/12-week percent change in each metric was estimated by area under the receiver operating characteristic curve (AUC). Repeatability was estimated by within-subject coefficient of variation (wCV). Results show that two-b-value ADC calculations provided non-inferior predictive value to four-b-value ADC calculations overall (AUCs = 0.60–0.61 versus AUC = 0.60) and for HR+/HER2− cancers where ADC was most predictive (AUCs = 0.75–0.78 versus AUC = 0.76), p < 0.05. Using two b-values (0/600 or 0/800 s/mm2) did not reduce ADC repeatability over the four-b-value calculation (wCVs = 4.9–5.2% versus 5.4%). The alternate metrics ADCfast (b ≤ 100 s/mm2), ADCslow (b ≥ 100 s/mm2), and fp did not improve predictive performance (AUCs = 0.54–0.60, p = 0.08–0.81), and ADCfast and fp demonstrated the lowest repeatability (wCVs = 6.71% and 12.4%, respectively). In conclusion, breast tumor ADC calculated using a simple two-b-value approach can provide comparable predictive value and repeatability to full four-b-value measurements as a marker of treatment response.
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影响因子：
6.7
作者：
Li X;Abramson RG;Arlinghaus LR;Kang H;Chakravarthy AB;Abramson VG;Farley J;Mayer IA;Kelley MC;Meszoely IM;Means-Powell J;Grau AM;Sanders M;Yankeelov TE
通讯作者：
Yankeelov TE
影响因子：
19.7
作者：
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3.4
作者：
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影响因子：
5.9
作者：
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作者：
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