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首页> 外文期刊>European radiology >Neoadjuvant chemotherapy in breast cancer-response evaluation and prediction of response to treatment using dynamic contrast-enhanced and diffusion-weighted MR imaging.
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Neoadjuvant chemotherapy in breast cancer-response evaluation and prediction of response to treatment using dynamic contrast-enhanced and diffusion-weighted MR imaging.

机译：使用动态对比增强和弥散加权MR成像对乳腺癌新辅助化疗的反应评估和治疗反应预测。

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OBJECTIVE: To explore the predictive value of MRI parameters and tumour characteristics before neoadjuvant chemotherapy (NAC) and to compare changes in tumour size and tumour apparent diffusion coefficient (ADC) during treatment, between patients who achieved pathological complete response (pCR) and those who did not. METHODS: Approval by the Regional Ethics Committee and written informed consent were obtained. Thirty-one patients with invasive breast carcinoma scheduled for NAC were enrolled (mean age, 50.7; range, 37-72). Study design included MRI before treatment (Tp0), after four cycles of NAC (Tp1) and before surgery (Tp2). Data in pCR versus non-pCR groups were compared and cut-off values for pCR prediction were evaluated. RESULTS: Before NAC, HER2 overexpression was the single significant predictor of pCR (p = 0.006). At Tp1 ADC, tumour size and changes in tumour size were all significantly different in the pCR and non-pCR groups. Using 1.42 x 10(-3) mm(2)/s as the cut-off value for ADC, pCR was predicted with sensitivity and specificity of 88% and 80%, respectively. Using a cut-off value of 83% for tumour volume reduction, sensitivity and specificity for pCR were 91% and 80%. CONCLUSION: ADC, tumour size and tumour size reduction at Tp1 were strong independent predictors of pCR.
机译：目的：探讨新辅助化疗（NAC）之前的MRI参数和肿瘤特征的预测价值，并比较在治疗期间，达到病理完全缓解（pCR）的患者与那些进行了病理完全缓解的患者之间的肿瘤大小和肿瘤表观弥散系数（ADC）的变化没有。方法：获得区域伦理委员会的批准和书面知情同意书。入选了计划用于NAC的31例浸润性乳腺癌患者（平均年龄50.7;范围37-72）。研究设计包括在治疗前（Tp0），NAC的四个周期后（Tp1）和手术前（Tp2）进行MRI。比较pCR组与非pCR组的数据，并评估pCR预测的临界值。结果：在NAC之前，HER2过表达是pCR的唯一重要预测因子（p = 0.006）。在Tp1 ADC上，pCR组和非pCR组的肿瘤大小和肿瘤大小变化均显着不同。使用1.42 x 10（-3）mm（2）/ s作为ADC的截止值，可以预测pCR的敏感性和特异性分别为88％和80％。使用83％的临界值减少肿瘤体积，对pCR的敏感性和特异性分别为91％和80％。结论：ADC，肿瘤大小和Tp1处的肿瘤缩小是pCR的强独立预测因子。

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