title: DCE-MRI analysis methods for predicting the response of breast cancer to neoadjuvant chemotherapy: pilot study findings.
abstract: OBJECTIVE
  The purpose of this pilot study is to determine (1) if early changes in both semiquantitative and quantitative DCE-MRI parameters, observed after the first cycle of neoadjuvant chemotherapy in breast cancer patients, show significant difference between responders and nonresponders and (2) if these parameters can be used as a prognostic indicator of the eventual response.
  
  
  METHODS
  Twenty-eight patients were examined using DCE-MRI pre-, post-one cycle, and just prior to surgery. The semiquantitative parameters included longest dimension, tumor volume, initial area under the curve, and signal enhancement ratio related parameters, while quantitative parameters included K(trans), v(e), k(ep), v(p), and τ(i) estimated using the standard Tofts-Kety, extended Tofts-Kety, and fast exchange regime models.
  
  
  RESULTS
  Our preliminary results indicated that the signal enhancement ratio washout volume and k(ep) were significantly different between pathologic complete responders from nonresponders (P < 0.05) after a single cycle of chemotherapy. Receiver operator characteristic analysis showed that the AUC of the signal enhancement ratio washout volume was 0.75, and the AUCs of k(ep) estimated by three models were 0.78, 0.76, and 0.73, respectively.
  
  
  CONCLUSIONS
  In summary, the signal enhancement ratio washout volume and k(ep) appear to predict breast cancer response after one cycle of neoadjuvant chemotherapy. This observation should be confirmed with additional prospective studies.
authors: Vanderbilt University Institute of Imaging Science (VUIIS), Vanderbilt University, Nashville, Tennessee, USA.
authors: Xia
authors: X
authors: Li
authors: Lori R
authors: LR
authors: Arlinghaus
authors: Gregory D
authors: GD
authors: Ayers
authors: A Bapsi
authors: AB
authors: Chakravarthy
authors: Richard G
authors: RG
authors: Abramson
authors: Vandana G
authors: VG
authors: Abramson
authors: Nkiruka
authors: N
authors: Atuegwu
authors: Jaime
authors: J
authors: Farley
authors: Ingrid A
authors: IA
authors: Mayer
authors: Mark C
authors: MC
authors: Kelley
authors: Ingrid M
authors: IM
authors: Meszoely
authors: Julie
authors: J
authors: Means-Powell
authors: Ana M
authors: AM
authors: Grau
authors: Melinda
authors: M
authors: Sanders
authors: Sandeep R
authors: SR
authors: Bhave
authors: Thomas E
authors: TE
authors: Yankeelov
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D010865:Pilot Projects; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
keywords: DCE-MRI; breast cancer; neoadjuvant therapy; treatment response
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