Diffusion-weighted MR Imaging: Pretreatment Prediction of Response to Neoadjuvant Chemotherapy in Patients with Breast Cancer
Diffusion-weighted MR Imaging: Pretreatment Prediction of Response to Neoadjuvant Chemotherapy in Patients with Breast Cancer
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DOI：
10.1148/radiol.10092021
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发表时间：
2010-10-01
期刊：
影响因子：
19.7
通讯作者：
Noh, Dong-Young
中科院分区：
文献类型：
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作者：
Park, Sang Hee;Moon, Woo Kyung;Noh, Dong-Young
目的：为了评估潜在的扩散加权（DW）磁共振（MR）成像与表观扩散系数（ADC）地图在预测乳腺癌患者的新辅助化疗的反应。材料和方法：这项回顾性研究是由机构审查委员会批准，放弃了知情同意的要求。纳入了53名连续女性（平均年龄43.7岁;中位年龄42.0岁;年龄范围24-65岁），53例浸润性乳腺癌（平均直径5.0 cm;中位直径4.2 cm;直径范围2.0-13.3 cm）接受化疗。在术前化疗前和化疗后，均在1.5 T下进行DW MR成像（B值，0和750 sec/mm（2））和动态对比剂增强（DCE）MR成像。从开始化疗到治疗后ADC测量的平均时间为54天（范围，48-62天）。计算ADC图上每个肿瘤三个感兴趣区域的平均ADC。化疗后DCE MR成像显示肿瘤直径缩小至少30%的患者被定义为应答者。比较治疗前ADC值和化疗后应答者和非应答者ADC值增加的百分比。结果：化疗后有36例（68%）患者为应答者，17例（32%）为无应答者。治疗前平均ADC（[1.036 +/- 0.015] x 10（-3）mm（2）/sec [标准误]）应答者显著低于无应答者（[1.299 +/- 0.079] x 10（-3）mm（2）/sec）（P=.004）。此外，应答者的平均ADC增加百分比（47.9% +/- 4.8）高于无应答者（18.1% +/- 4.5）（P
Purpose: To evaluate the potential of diffusion-weighted (DW) magnetic resonance (MR) imaging with an apparent diffusion coefficient (ADC) map in the prediction of response to neoadjuvant chemotherapy in patients with breast cancer.Materials and Methods: This retrospective study was approved by the institutional review board, which waived the informed consent requirement. Fifty-three consecutive women (mean age, 43.7 years; median age, 42.0 years; age range, 24-65 years) with 53 invasive breast cancers (mean diameter, 5.0 cm; median diameter, 4.2 cm; diameter range, 2.0-13.3 cm) who had undergone chemotherapy were included. Both DW MR imaging (b values, 0 and 750 sec/mm(2)) and dynamic contrast material-enhanced (DCE) MR imaging were performed at 1.5 T before and after chemotherapy prior to surgery. Mean time from initiation of chemotherapy to posttreatment ADC measurement was 54 days (range, 48-62 days). Average ADC for three regions of interest per tumor on ADC maps was calculated. Patients with a reduction in tumor diameter of at least 30% after chemotherapy at DCE MR imaging were defined as responders. Pretreatment ADCs and percentage increases in ADC after chemotherapy in responders and nonresponders were compared. The best pretreatment ADC cutoff with which to differentiate between responders and nonresponders was calculated with receiver operating characteristic curve analysis.Results: After chemotherapy, 36 (68%) patients were classified as responders, and 17 (32%) were classified as nonresponders. Pretreatment mean ADC ([1.036 +/- 0.015] x 10(-3) mm(2)/sec [standard error]) of responders was significantly lower than that of nonresponders ([1.299 +/- 0.079] x 10(-3) mm(2)/sec) (P=.004). Furthermore, mean percentage ADC increase of responders (47.9% +/- 4.8) was higher than that of nonresponders (18.1% +/- 4.5) (P