title: Treatment Response Evaluation of Breast Cancer after Neoadjuvant Chemotherapy and Usefulness of the Imaging Parameters of MRI and PET/CT.
abstract: This study was aimed to evaluate the ability of imaging parameters measured on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), diffusion-weighted MRI (DWI) and positron emission tomography/computed tomography (PET/CT) to serve as response markers in breast cancer after neoadjuvant chemotherapy (NAC). In 20 patients with breast cancer, DCE-MRI and DWI using a 3 T scanner and PET/CT were performed before and after NAC. DCE-MRI was analyzed using an automatic computer-aided detection program (MR-CAD). The response imaging parameters were compared with the pathologic response. The areas under the curve (AUCs) for DCE-MRI using MR-CAD analysis, DWI and PET/CT were 0.77, 0.59 and 0.76, respectively. The combination of all parameters measured by MR-CAD showed the highest diagnostic performance and accuracy (AUC = 0.77, accuracy = 90%). The combined use of the parameters of PET/CT with DCE-MRI or DWI showed a trend toward improved specificity and negative predictive value (100%, 100%, accuracy = 87.5%). The use of DCE-MRI using MR-CAD parameters indicated better diagnostic performance in predicting the final pathological response compared with DWI and PET/CT, although no statistically significant difference was observed. The combined use of PET/CT with DCE-MRI or DWI may improve the specificity for predicting a pathological response.
authors.affiliation: Department of Radiology, College of Medicine, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.
authors.forename: Yeong Yi
authors.identifier: 0000-0003-0905-8498
authors.initials: YY
authors.lastname: An
authors.affiliation: Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.
authors.forename: Sung Hun
authors.identifier: 0000-0003-4478-9720
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.
authors.forename: Bong Joo
authors.identifier: 0000-0002-5991-6035
authors.initials: BJ
authors.lastname: Kang
authors.affiliation: Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea.
authors.forename: Ah Won
authors.identifier: 0000-0002-2523-9531
authors.initials: AW
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography / Q000379:methods; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D020360:Neoadjuvant Therapy / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
keywords: Breast Neoplasm; Diffusion-weighted MRI; Dynamic Contrast-enhanced MRI; Neoadjuvant Chemotherapy; Pathologic Response; Positron Emission Tomography