Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Early Prediction of Response to Neoadjuvant Chemotherapy Using Dynamic Contrast-Enhanced MRI and Ultrasound in Breast Cancer

  • Kim, Yunju (Department of Radiology, National Cancer Center) ;
  • Kim, Sung Hun (Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Song, Byung Joo (Department of Surgery, College of Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Kang, Bong Joo (Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Yim, Kwang-il (Department of Pathology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Lee, Ahwon (Department of Pathology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Nam, Yoonho (Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea)
  • Received : 2017.09.29
  • Accepted : 2018.01.15
  • Published : 2018.08.01
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Abstract

Objective: To determine the diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and DCE ultrasound (DCE-US) for predicting response to neoadjuvant chemotherapy (NAC) in breast cancer patients. Materials and Methods: This Institutional Review Board-approved prospective study was performed between 2014 and 2016. Thirty-nine women with breast cancer underwent DCE-US and DCE-MRI before the NAC, follow-up DCE-US after the first cycle of NAC, and follow-up DCE-MRI after the second cycle of NAC. DCE-MRI parameters (transfer constant [$K_{trans}$], reverse constant [$k_{ep}$], and leakage space [$V_e$]) were assessed with histograms. From DCE-US, peak-enhancement, the area under the curve, wash-in rate, wash-out rate, time to peak, and rise time (RT) were obtained. After surgery, all the imaging parameters and their changes were compared with histopathologic response using the Miller-Payne Grading (MPG) system. Data from minor and good responders were compared using Wilcoxon rank sum test, chi-square test, or Fisher's exact test. Receiver operating characteristic curve analysis was used for assessing diagnostic performance to predict good response. Results: Twelve patients (30.8%) showed a good response (MPG 4 or 5) and 27 (69.2%) showed a minor response (MPG 1-3). The mean, 25th, 50th, and 75th percentiles of $K_{trans}$ and $K_{ep}$ of post-NAC DCE-MRI differed between the two groups. These parameters showed fair to good diagnostic performance for the prediction of response to NAC (AUC 0.76-0.81, $p{\leq}0.007$). Among DCE-US parameters, the percentage change in RT showed fair prediction (AUC 0.71, p = 0.023). Conclusion: Quantitative analysis of DCE-MRI and DCE-US was helpful for early prediction of response to NAC.

Keywords

Acknowledgement

Supported by : Korea Health Industry Development Institute (KHIDI)

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