title: Quantitative DCE-MRI for prediction of pathological complete response following neoadjuvant treatment for locally advanced breast cancer: the impact of breast cancer subtypes on the diagnostic accuracy.
abstract: OBJECTIVE
  To assess whether DCE-MRI pharmacokinetic (PK) parameters obtained before and during chemotherapy can predict pathological complete response (pCR) differently for different breast cancer groups.
  
  
  METHODS
  Eighty-four patients who received neoadjuvant chemotherapy for locally advanced breast cancer were retrospectively included. All patients underwent two DCE-MRI examinations, one before (EX1) and one during treatment (EX2). Tumours were classified into different breast cancer groups, namely triple negative (TNBC), HER2+ and ER+/HER2-, and compared with the whole population (WP). PK parameters Ktrans and Ve were extracted using a two-compartment Tofts model.
  
  
  RESULTS
  At EX1, Ktrans predicted pCR for WP and TNBC. At EX2, maximum diameter (Dmax) predicted pCR for WP and ER+/HER2-. Both PK parameters predicted pCR in WP and TNBC and only Ktrans for the HER2+. pCR was predicted from relative difference (EX1 - EX2)/EX1 of Dmax and both PK parameters in the WP group and only for Ve in the TNBC group. No PK parameter could predict response for ER+/HER-. ROC comparison between WP and breast cancer groups showed higher but not statistically significant values for TNBC for the prediction of pCR CONCLUSIONS: Quantitative DCE-MRI can better predict pCR after neoadjuvant treatment for TNBC but not for the ER+/HER2- group.
  
  
  CONCLUSIONS
  • DCE-MRI-derived pharmacokinetic parameters can predict response status of neoadjuvant chemotherapy treatment. • Ktrans can better predict pCR for the triple negative group. • No pharmacokinetic parameter could predict response for the ER+/HER2- group.
authors: Radiology Department, Institute Jules Bordet, 1 Rue Heger Bordet, Brussels, 1000, Belgium. stylianos.drisis@bordet.be.
authors: Stylianos
authors: http://orcid.org/0000-0001-8936-1598
authors: S
authors: Drisis
authors: Radiology Department, Erasme University Hospital, Brussels, 1070, Belgium.
authors: Thierry
authors: T
authors: Metens
authors: Oncology Department, Institute Jules Bordet, Brussels, 1000, Belgium.
authors: Michael
authors: M
authors: Ignatiadis
authors: Radiology Department, Institute Jules Bordet, 1 Rue Heger Bordet, Brussels, 1000, Belgium.
authors: Konstantinos
authors: K
authors: Stathopoulos
authors: Radiology Department, Institute Jules Bordet, 1 Rue Heger Bordet, Brussels, 1000, Belgium.
authors: Shih-Li
authors: SL
authors: Chao
authors: Radiology Department, Institute Jules Bordet, 1 Rue Heger Bordet, Brussels, 1000, Belgium.
authors: Marc
authors: M
authors: Lemort
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D018275:Carcinoma, Lobular / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D012074:Remission Induction / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D064726:Triple Negative Breast Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery
keywords: Breast cancer; Neoadjuvant therapy; Oestrogen receptor; Perfusion magnetic resonance imaging; Triple negative breast cancer