Predicting Survival and Early Clinical Response to Primary Chemotherapy for Patients With Locally Advanced Breast Cancer Using DCE-MRI
Predicting Survival and Early Clinical Response to Primary Chemotherapy for Patients With Locally Advanced Breast Cancer Using DCE-MRI
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DOI：
10.1002/jmri.21778
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发表时间：
2009-06-01
影响因子：
4.4
通讯作者：
Gribbestad, Ingrid S.
中科院分区：
文献类型：
--
作者：
Johansen, Roar;Jensen, Line R.;Gribbestad, Ingrid S.
目的：评估动态对比增强磁共振成像 (DCE-MRI) 作为早期预测局部晚期乳腺癌患者新辅助化疗 (NAC) 反应和 5 年生存率的工具。 材料和方法：在第一个治疗周期之前和之后对计划接受 NAC 的患者 (n = 24) 进行 DCE-MRI。完成 NAC 后评估临床反应。根据 DCE 曲线计算相对信号强度 (RSI) 和曲线下面积 (AUC)，并与临床治疗反应进行比较。 Kohonen和概率神经网络（KNN和PNN）分析用于预测5年生存率。结果：临床治疗反应的患者仅经过一个周期的NAC后RSI和AUC就降低了（P = 0.02和P = 0.08）。与非幸存者相比，生存超过 5 年的患者在 NAC 之前的平均 RSI 值和第 10 个百分位 RSI 值显着较低（P = 0.05 和 0.02）。这种关系得到了 KNN 的证实，它表明仍然活着的患者与死亡患者聚集在不同的区域。通过 PNN 对患者 5 年生存率的对比增强曲线进行校准，训练和测试的敏感性和特异性范围为 80%-92%。结论：局部晚期乳腺癌的 DCE-MRI 有可能预测小型患者队列的 5 年生存率。此外，还可以评估一个 NAC 周期后肿瘤血管化的变化。
Purpose: To evaluate dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) as a tool for early prediction of response to neoadjuvant chemotherapy (NAC) and 5-year survival in patients with locally advanced breast cancer.Materials and Methods: DCE-MRI was performed in patients scheduled for NAC (n = 24) before and after the first treatment cycle. Clinical response was evaluated after completed NAC. Relative signal intensity (RSI) and area under the curve (AUC) were calculated from the DCE-curves and compared to clinical treatment response. Kohonen and probabilistic neural network (KNN and PNN) analysis were used to predict 5-year survival.Results: RSI and AUC were reduced after only one cycle of NAC in patients with clinical treatment response (P = 0.02 and P = 0.08). The mean and 10th percentile RSI values before NAC were significantly lower in patients Surviving more than 5 years compared to nonsurvivors (P = 0.05 and 0,02). This relationship was confirmed using KNN, which demonstrated that patients who remained alive Clustered in separate regions from those that died. Calibration of contrast enhancement curves by PNN for patient survival at 5 years yielded sensitivity and specificity for training and testing ranging from 80%-92%.Conclusion: DCE-MRI in locally advanced breast cancer has the potential to predict 5-year survival in a small patient cohort. In addition, changes in tumor vascularization after one cycle of NAC can be assessed.