Multiparametric magnetic resonance imaging for predicting pathological response after the first cycle of neoadjuvant chemotherapy in breast cancer.
Multiparametric magnetic resonance imaging for predicting pathological response after the first cycle of neoadjuvant chemotherapy in breast cancer.
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DOI：
10.1097/rli.0000000000000100
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发表时间：
2015-04
影响因子：
6.7
通讯作者：
Yankeelov TE
中科院分区：
文献类型：
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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
确定在新辅助化疗（NAC）的第一个周期之前和之后获得的动态对比增强磁共振成像（DCE-MRI）和弥散加权MRI（DW-MRI）的联合测量值是否上级预测乳腺癌患者病理完全缓解（pCR）的单参数测量值。II/III期乳腺癌患者入组IRB批准的研究，在NAC治疗前（n = 37）和1个周期后（n = 33）采集3 T DCE和DW-MRI数据。使用扩展Tofts-Kety（ETK）模型，根据DCE-MRI数据生成Ktranss、ve、vp和kep（= Ktranss/ve）的估计值。根据DW-MRI数据估计表观扩散系数（ADC）。将导出的参数kep/ADC与单参数测量值进行比较，以确定其预测NAC第一个周期后pCR的能力。第一个周期NAC后的kep/ADC值区分了继续达到pCR的患者（P < 0.001），并达到了灵敏度、特异性、阳性预测值和受试者工作曲线下面积（AUC）分别为0.92、0.75、0.69和0.86。这些值上级单一参数kep（AUC = 0.77）和ADC（AUC = 0.81）。基于自举95% CI（0.0062，0.20），kep/ADC和kep之间的AUC存在显著差异，而kep/ADC和ADC之间的AUC趋于显著性（-0.12，0.24）。联合分析DCE-MRI和DW-MRI参数预测NAC第一个周期后pCR的效果优于单参数测量值，优于上级。
To determine if combined measurements from dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) and diffusion weighted MRI (DW-MRI), obtained before and after the first cycle of neoadjuvant chemotherapy (NAC), are superior to single parameter measurements for predicting pathological complete response (pCR) in breast cancer patients. Patients with Stage II/III breast cancer were enrolled in an IRB-approved study in which 3T DCE- and DW-MRI data were acquired before (n = 37) and after one cycle (n = 33) of NAC. Estimates of Ktrans, ve, vp, and kep (= Ktrans/ve) were generated from the DCE-MRI data using the Extended Tofts-Kety (ETK) model. The apparent diffusion coefficient (ADC) was estimated from the DW-MRI data. The derived parameter kep/ADC was compared to single parameter measurements for its ability to predict pCR after the first cycle of NAC. kep/ADC after the first cycle of NAC discriminated patients who went on to achieve a pCR (P < 0.001), and achieved a sensitivity, specificity, positive predictive value, and area under the receiver operator curve (AUC) of 0.92, 0.75, 0.69, and 0.86, respectively. These values were superior to the single parameters kep (AUC = 0.77) and ADC (AUC = 0.81). The AUCs between kep/ADC and kep were significantly different based on the bootstrapped 95% CIs (0.0062, 0.20), while the AUCs between kep/ADC and ADC trended towards significance (−0.12, 0.24). A combined analysis of DCE-MRI and DW-MRI parameters was superior to single-parameter measurements for predicting pCR after the first cycle of NAC.