McGill University Health Center, Radiology Department, Glen site, 1001, boulevard Décarie, H4A3J1 Quebec, Montreal, Canada; Radiology Department, Institut Bergonié, 229, cours de l'Argonne, 33000 Bordeaux, France.
McGill University Health Center, Radiology Department, Glen site, 1001, boulevard Décarie, H4A3J1 Quebec, Montreal, Canada.
Diagn Interv Imaging. 2018 Dec;99(12):773-781. doi: 10.1016/j.diii.2018.09.001. Epub 2018 Oct 22.
To evaluate whether enhancement of breast cancer on pre-treatment dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) as evaluated semi-quantitatively using computer-aided detection (CAD) is associated with response to neo-adjuvant chemotherapy.
A total of 84 women, (mean age, 51±10 [SD] years; range: 30-73 years) with 84 breast cancers who underwent MRI before neo-adjuvant chemotherapy were included in this retrospective study. The proportion of each type of signal intensity-time curve (SITC) (type 1: persistent; type 2: plateau; Type 3: washout) within the tumor volume was quantified semi-automatically using a CAD system (Aegis, Sentinelle medical, Toronto, Canada) and was compared to histological features of the tumors and to pathological response to neo-adjuvant chemotherapy.
Pathological complete response was obtained in 29 patients (35%). Proportion of SITC type 1 was greater in non-responders (P=0.019) while proportion of SITC type 3 was greater in responders (P=0.04). Sensitivity, specificity, and accuracy of proportion of SITC type 1 for the identification of incomplete response on pathology were 42% (95% CI: 29%-56%), 90% (95% CI: 73%-98%), and 59% (95% CI: 48%-70%), respectively.
Proportion of SITC type 1 (persistent) in breast cancers on pre-treatment MRI as semi-automatically quantified using a CAD system is associated with absence of pathological complete response to neo-adjuvant chemotherapy with good specificity.
评估使用计算机辅助检测（CAD）半定量评估的预处理动态对比增强磁共振成像（DCE-MRI）增强是否与新辅助化疗的反应相关。
本回顾性研究共纳入 84 名女性（平均年龄 51±10[SD]岁；范围：30-73 岁），84 例乳腺癌患者在新辅助化疗前接受 MRI 检查。使用 CAD 系统（Aegis，Sentinelle medical，多伦多，加拿大）半自动定量肿瘤体积内每种类型信号强度时间曲线（SITC）（类型 1：持续；类型 2：平台；类型 3：洗脱）的比例，并将其与肿瘤的组织学特征和新辅助化疗的病理反应进行比较。
29 例患者（35%）获得病理完全缓解。非应答者中 SITC 类型 1 的比例更高（P=0.019），而应答者中 SITC 类型 3 的比例更高（P=0.04）。比例 SITC 类型 1 用于识别病理不完全反应的灵敏度、特异性和准确性分别为 42%（95%CI：29%-56%）、90%（95%CI：73%-98%）和 59%（95%CI：48%-70%）。
使用 CAD 系统半自动定量的预处理 MRI 上 SITC 类型 1（持续）的比例与新辅助化疗后病理完全缓解缺失相关，特异性较好。
