title: Predictive value of DCE-MRI for early evaluation of pathological complete response to neoadjuvant chemotherapy in resectable primary breast cancer: A single-center prospective study.
abstract: OBJECTIVE
  This study proposed to establish a predictive model using dynamic enhanced MRI multi-parameters for early predicting pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) in breast cancer.
  
  
  METHODS
  In this prospective cohort study, 170 breast cancer patients treated with NAC were enrolled and were randomly grouped into training sample (136 patients) and validation sample (34 patients). DCE-MRI parameters achieved at the end of the first cycle of NAC were screened to establish the predictive model by using multivariate logistic regression model according to pCR status. Receiver operating characteristic curves were conducted to assess the predictive capability. The association between MRI-predicted pCR and actual pCR in survival outcomes was estimated by using the Kaplan-Meier method with log-rank test.
  
  
  RESULTS
  Multivariate analysis showed ΔAreamax and ΔSlopemax were independent predictors for pCR, odds ratio were 0.939 (95%CI, 0.915 to 0.964), and 0.966 (95%CI, 0.947 to 0.986), respectively. A predictive model was established using training sample as "Y = -0.063*ΔAreamax - 0.034*ΔSlopemax", a cut-off point of 3.0 was determined. The AUC for training and validation sample were 0.931 (95%CI, 0.890-0.971) and 0.971 (95%CI, 0.923-1.000), respectively. MRI-predicted pCR patients showed similar RFS (p = 0.347), DDFS (p = 0.25) and OS (p = 0.423) with pCR patients.
  
  
  CONCLUSIONS
  The multi-parameter MRI model can be potentially used for early prediction of pCR status at the end of the first NAC cycle, which might allow timely regimen refinement before definitive surgical treatment.
authors.affiliation: From Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, 100142, China. Electronic address: sys27@163.com.
authors.forename: Ying-Shi
authors.initials: YS
authors.lastname: Sun
authors.affiliation: From Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Breast Center, Peking University Cancer Hospital & Institute, Beijing, 100142, China.
authors.forename: Ying-Jian
authors.initials: YJ
authors.lastname: He
authors.affiliation: From Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, 100142, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.affiliation: From Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, 100142, China.
authors.forename: Yan-Ling
authors.initials: YL
authors.lastname: Li
authors.affiliation: From Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, 100142, China.
authors.forename: Xiao-Ting
authors.initials: XT
authors.lastname: Li
authors.affiliation: From Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Pathology, Peking University Cancer Hospital & Institute, Beijing, 100142, China.
authors.forename: Ai-Ping
authors.initials: AP
authors.lastname: Lu
authors.affiliation: From Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Breast Center, Peking University Cancer Hospital & Institute, Beijing, 100142, China.
authors.forename: Zhao-Qing
authors.initials: ZQ
authors.lastname: Fan
authors.affiliation: From Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, 100142, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Cao
authors.affiliation: From Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Breast Center, Peking University Cancer Hospital & Institute, Beijing, 100142, China. Electronic address: ouyanghongtao@263.net.
authors.forename: Tao
authors.initials: T
authors.lastname: Ouyang
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D003287:Contrast Media; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D000970:Antineoplastic Agents; D003287:Contrast Media
keywords: Breast cancer; Magnetic resonance imaging; Pathological complete response; Prediction; Therapeutic response