Abstract | PURPOSE: This study compared the performance of diffusion-weighted imaging (DWI) to dynamic contrast-enhanced (DCE)-MRI for diagnosing pathological complete response (pCR) before surgery. METHOD: Overall, 133 lesions from 133 patients who underwent pre-surgical MRI evaluation after neoadjuvant systemic treatment were included. Two readers blinded to the pathological diagnosis evaluated the images. MR images were obtained using a routine protocol sequence that included DWI and DCE-MRI. DWI of the target lesion was scored using a three-point scale. Kinetic patterns of lesions on DCE-MRI were scored using a four-point scale. The capacities of DWI and kinetic parameters for discriminating pCR and non-pCR were assessed via receiver operating characteristic (ROC) analysis. RESULTS: For DWI scores, ROC analysis showed areas under the ROC curve (AUCs) of 0.84 (95% confidence interval: 0.77-0.90) and 0.85 (0.77-0.90) for readers 1 and 2, respectively; corresponding AUCs of kinetic scores were 0.89 (0.82-0.94) and 0.88 (0.81-0.93). Among the triple-negative subtype, the AUCs of DWI scores were 0.84 (0.70-0.93) and 0.88 (0.75-0.96) for readers 1 and 2, respectively; corresponding AUCs of kinetic scores were 0.94 (0.83-0.99) and 0.93 (0.82-0.99). Among the luminal subtype, the AUCs of DWI scores were 0.85 (0.71-0.94) and 0.82 (0.68-0.92) for readers 1 and 2, respectively; corresponding AUCs of kinetic scores were 0.82 (0.68-0.92) and 0.72 (0.56-0.85). CONCLUSIONS: Our DWI-based visual score and kinetic score showed similar diagnostic performances. Both DWI and kinetic scores tended to perform better in predicting pCR for the triple-negative subtype.
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Authors | Rie Ota, Masako Kataoka, Mami Iima, Maya Honda, Akane Ohashi, Ayami Ohno Kishimoto, Kanae Kawai Miyake, Yosuke Yamada, Yasuhide Takeuchi, Masakazu Toi, Yuji Nakamoto |
Journal | European journal of radiology
(Eur J Radiol)
Vol. 154
Pg. 110372
(Sep 2022)
ISSN: 1872-7727 [Electronic] Ireland |
PMID | 35667297
(Publication Type: Journal Article)
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Copyright | Copyright © 2022 Elsevier B.V. All rights reserved. |
Chemical References |
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Topics |
- Breast Neoplasms
(diagnostic imaging, drug therapy, surgery)
- Contrast Media
- Diffusion Magnetic Resonance Imaging
(methods)
- Female
- Humans
- Kinetics
- Magnetic Resonance Imaging
(methods)
- Neoadjuvant Therapy
(methods)
- Retrospective Studies
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