Department of Radiology, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, 1-10, Ami-Dong, Seo-gu, Busan, 602-739, Republic of Korea.
Eur Radiol. 2023 Jan;33(1):440-449. doi: 10.1007/s00330-022-08998-8. Epub 2022 Jul 18.
To evaluate whether the computer-aided diagnosis (CAD)-extracted kinetic heterogeneity of breast cancer on MRI and changes therein during treatment were associated with the pathological response to neoadjuvant systemic therapy (NST).
Consecutive patients with invasive breast cancer, who underwent NST followed by surgery between 2014 and 2020, were retrospectively evaluated. Using a commercial CAD system, kinetic features (angiovolume, peak enhancement, delayed enhancement profiles, and kinetic heterogeneity) of breast cancer were assessed with pre- and mid-treatment MRI. Multivariate logistic regression was used to identify the associations between CAD-extracted kinetic features and pathological complete response (pCR).
A total of 130 patients (mean age, 55 years) were included, 37 (28.5%) of whom achieved a pCR. When the pre- and mid-treatment MRI data were compared, the pCR group exhibited greater changes in kinetic heterogeneity (86.14 ± 32.05% vs. 8.50 ± 141.01%, p < 0.001) and angiovolume (95.20 ± 14.29% vs. 19.89 ± 320.16%; p < 0.001) than the non-pCR group. Multivariate regression analysis showed that a large change in kinetic heterogeneity (odds ratio (OR) = 1.030, p < 0.001), age (OR = 0.931, p = 0.005), progesterone receptor negativity (OR = 7.831, p = 0.001), and HER2 positivity (OR = 3.455, p = 0.017) were associated with pCR.
A greater change in the CAD-extracted kinetic heterogeneity of breast cancer between pre- and mid-treatment MRI was associated with a pCR in patients on NST.
A greater change in kinetic heterogeneity was associated with a pathological complete response. Computer-aided diagnosis-extracted kinetic heterogeneity might serve as a quantitative biomarker of therapeutic efficacy.
评估磁共振成像（MRI）上计算机辅助诊断（CAD）提取的乳腺癌动力学异质性及其在治疗过程中的变化是否与新辅助全身治疗（NST）的病理反应相关。
回顾性分析了 2014 年至 2020 年间接受 NST 后手术的连续浸润性乳腺癌患者。使用商业 CAD 系统，评估了乳腺癌的动力学特征（血管容积、峰值增强、延迟增强曲线和动力学异质性）在治疗前后的 MRI。多变量逻辑回归用于确定 CAD 提取的动力学特征与病理完全缓解（pCR）之间的关联。
共纳入 130 例患者（平均年龄 55 岁），其中 37 例（28.5%）达到了 pCR。与非 pCR 组相比，pCR 组治疗前后 MRI 数据比较时，动力学异质性（86.14 ± 32.05% vs. 8.50 ± 141.01%，p < 0.001）和血管容积（95.20 ± 14.29% vs. 19.89 ± 320.16%；p < 0.001）的变化更大。多变量回归分析表明，动力学异质性的较大变化（比值比（OR）= 1.030，p < 0.001）、年龄（OR = 0.931，p = 0.005）、孕激素受体阴性（OR = 7.831，p = 0.001）和 HER2 阳性（OR = 3.455，p = 0.017）与 pCR 相关。
NST 患者治疗前后 MRI 上 CAD 提取的乳腺癌动力学异质性的较大变化与 pCR 相关。
动力学异质性的较大变化与 pCR 相关。CAD 提取的动力学异质性可能成为治疗效果的定量生物标志物。
