title: Investigating the prediction value of multiparametric magnetic resonance imaging at 3 T in response to neoadjuvant chemotherapy in breast cancer.
abstract: OBJECTIVE
  To explore the predictive value of parameters derived from diffusion-weighted imaging (DWI) and contrast-enhanced (CE)-MRI at different time-points during neoadjuvant chemotherapy (NACT) in breast cancer.
  
  
  METHODS
  Institutional review board approval and written, informed consent from 42 breast cancer patients were obtained. The patients were investigated before and at three different time-points during neoadjuvant chemotherapy (NACT) using tumour diameter and volume from CE-MRI and ADC values obtained from drawn 2D and segmented 3D regions of interest. Prediction of pathologic complete response (pCR) was evaluated using the area under the curve (AUC) of receiver operating characteristic analysis.
  
  
  RESULTS
  There was no significant difference between pathologic complete response and non-pCR in baseline size measures (p > 0.39). Diameter change was significantly different in pCR (p < 0.02) before the mid-therapy point. The best predictor was lesion diameter change observed before mid-therapy (AUC = 0.93). Segmented volume was not able to differentiate between pCR and non-pCR at any time-point. The ADC values from 3D-ROI were not significantly different from 2D data (p = 0.06). The best AUC (0.79) for pCR prediction using DWI was median ADC measured before mid-therapy of NACT.
  
  
  CONCLUSIONS
  The results of this study should be considered in NACT monitoring planning, especially in MRI protocol designing and time point selection.
  
  
  CONCLUSIONS
  • Mid-therapy diameter changes are the best predictors of pCR in neoadjuvant chemotherapy. • Volumetric measures are not strictly superior in therapy monitoring to lesion diameter. • Size measures perform as a better predictor than ADC values.
authors.affiliation: High-field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Lazarettgasse 14, 1090, Vienna, Austria.|Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria.
authors.forename: Lenka
authors.initials: L
authors.lastname: Minarikova
authors.affiliation: High-field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Lazarettgasse 14, 1090, Vienna, Austria.|Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Bogner
authors.affiliation: Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.|Memorial Sloan-Kettering Cancer Center, Molecular Imaging and Therapy Service, New York, NY, USA.
authors.forename: Katja
authors.initials: K
authors.lastname: Pinker
authors.affiliation: High-field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Lazarettgasse 14, 1090, Vienna, Austria.|Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria.|Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia.|University of Oxford, John Radcliffe Hospital, Oxford Centre for Clinical Magnetic Resonance Research, Oxford, UK.
authors.forename: Ladislav
authors.initials: L
authors.lastname: Valkovič
authors.affiliation: High-field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Lazarettgasse 14, 1090, Vienna, Austria.|Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria.
authors.forename: Olgica
authors.initials: O
authors.lastname: Zaric
authors.affiliation: Department of Pathology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Bago-Horvath
authors.affiliation: Clinical Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
authors.forename: Rupert
authors.initials: R
authors.lastname: Bartsch
authors.affiliation: Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Helbich
authors.affiliation: High-field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Lazarettgasse 14, 1090, Vienna, Austria.|Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria.
authors.forename: Siegfried
authors.initials: S
authors.lastname: Trattnig
authors.affiliation: High-field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Lazarettgasse 14, 1090, Vienna, Austria. stephan.gruber@meduniwien.ac.at.|Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria. stephan.gruber@meduniwien.ac.at.
authors.forename: Stephan
authors.identifier: http://orcid.org/0000-0001-5115-6273
authors.initials: S
authors.lastname: Gruber
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D019540:Area Under Curve; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000188:drug therapy* / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D012372:ROC Curve; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: Breast; Contrast-Enhanced Magnetic Resonance Imaging; Diffusion Weighted Imaging; Neoadjuvant Chemotherapy; Neoplasms