Department of Radiology, The University of Chicago, Chicago, IL 60637, United States of America.
Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15260, United States of America.
Magn Reson Imaging. 2023 Dec;104:9-15. doi: 10.1016/j.mri.2023.08.003. Epub 2023 Aug 21.
To assess whether measurement of the bilateral asymmetry of semiquantitative and quantitative perfusion parameters from ultrafast dynamic contrast-enhanced MRI (DCE-MRI), allows early prediction of pathologic response after neoadjuvant chemotherapy (NAC) in patients with HER2+ breast cancer.
Twenty-eight female patients with HER2+ breast cancer treated with NAC who underwent pre-NAC ultrafast DCE-MRI (3-9 s/phase) were enrolled for this study. Four semiquantitative and two quantitative parenchymal parameters were calculated for each patient. Ipsilateral/contralateral (I/C) ratio (for four parameters) and the difference between (for two parameters) ipsi- and contra-lateral parenchymal kinetic parameters (kBPE) were compared for patients with pathologic complete response (pCR) and those having residual disease. Lasso regression with leave-one-out cross validation was used to determine the optimal combination of parameters for a regression model and multivariable logistic regression was used to identify independent predictors for pCR. Chi-squared test, two-sided t-test and Kruskal-Wallis test were used.
The K I/C ratio cutoff value of 1.11 had a sensitivity of 83.3% and specificity of 75% for pCR. The v I/C ratio cutoff value of 1.1 had a sensitivity of 75% and specificity of 81.3% for pCR. The area under the receiver operating characteristic curve of the three-kBPE parameter model, including initial area under the enhancement curve (AUC30) I/C ratio, KI/C ratio and v I/C ratio, was 0.89 with sensitivity of 91.7% at specificity of 81.3%.
Quantitative assessment of bilateral asymmetry kBPE from pre-NAC ultrafast DCE-MRI can predict pCR in patients with HER2+ breast cancer.
评估超快速动态对比增强磁共振成像（DCE-MRI）半定量和定量灌注参数的双侧不对称性测量是否可以预测 HER2+乳腺癌患者新辅助化疗（NAC）后的病理反应。
本研究纳入了 28 例接受 NAC 治疗的 HER2+乳腺癌女性患者，这些患者在 NAC 前接受了超快速 DCE-MRI（3-9 s/期）检查。为每位患者计算了四个半定量和两个定量实质参数。比较了病理完全缓解（pCR）患者和残留疾病患者的同侧/对侧（I/C）比值（四个参数）和同侧和对侧实质动力学参数（kBPE）之间的差值（两个参数）。采用带有留一交叉验证的套索回归确定回归模型的最佳参数组合，并采用多变量逻辑回归识别 pCR 的独立预测因子。采用卡方检验、双侧 t 检验和 Kruskal-Wallis 检验。
K I/C 比值的截断值为 1.11 时，对 pCR 的灵敏度为 83.3%，特异性为 75%。V I/C 比值的截断值为 1.1 时，对 pCR 的灵敏度为 75%，特异性为 81.3%。包括初始增强曲线下面积（AUC30）I/C 比值、KI/C 比值和 V I/C 比值在内的三个-kBPE 参数模型的受试者工作特征曲线下面积为 0.89，灵敏度为 91.7%，特异性为 81.3%。
NAC 前超快速 DCE-MRI 双侧不对称性定量评估 kBPE 可预测 HER2+乳腺癌患者的 pCR。
