Almutlaq, Z.M., Wilson, D.J., Bacon, S.E. et al. (4 more authors) (2022) Evaluation of Monoexponential, Stretched-Exponential and Intravoxel Incoherent Motion MRI Diffusion Models in Early Response Monitoring to Neoadjuvant Chemotherapy in Patients With Breast Cancer—A Preliminary Study. Journal of Magnetic Resonance Imaging, 56 (4). pp. 1079-1088. ISSN 1053-1807
Abstract
Background There has been a growing interest in exploring the applications of stretched-exponential (SEM) and intravoxel incoherent motion (IVIM) models of diffusion-weighted imaging (DWI) in breast imaging, with the focus on differentiation of breast lesions. However, the use of SEM and IVIM models to predict early response to neoadjuvant chemotherapy (NACT) has received less attention.
Purpose To investigate the value of monoexponential, SEM, and IVIM models to predict early response to NACT in patients with primary breast cancer.
Study Type Prospective.
Population Thirty-seven patients with primary breast cancer (aged 46 ± 11 years) due to undergo NACT.
Field Strength/Sequences A 1.5-T MR scanner, T1-weighted three-dimensional spoiled gradient-echo, two-dimensional single-shot spin-echo echo-planar imaging sequence (DWI) at six b-values (0–800 s mm−2).
Assessment Tumor volume, apparent diffusion coefficient, tissue diffusion (Dt), pseudo-diffusion coefficient (Dp), perfusion fraction (f), distributed diffusion coefficient, and alpha (α) were extracted, following volumetric sampling of the tumors, at three time-points: pretreatment, post one and three cycles of NACT.
Statistical Tests Mann–Whitney test, receiver operating characteristic (ROC) curve. Statistical significance level was P < 0.05.
Results Following NACT, 17 patients were determined to be pathological responders and 20 nonresponders. Tumor volume was significantly larger in nonresponders at each MRI time-point and demonstrated reasonable performance in predicting response (area under the ROC curve [AUC] = 0.83–0.87). No significant differences between groups were found in the diffusion coefficients at each time-point (P = 0.09–1). The parameters α (SEM), f, and f × Dp (IVIM) were able to differentiate between response groups after one cycle of NACT (AUC = 0.73, 0.72, and 0.74, respectively).
Conclusion Diffusion coefficients derived from the monoexponential, SEM, and IVIM models did not predict pathological response. However, the IVIM-derived parameters f and f × Dp and the SEM-derived parameter α were able to predict response to NACT in breast cancer patients following one cycle of NACT.
Level of Evidence 2
Technical Efficacy Stage 2
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2022 The Authors. This is an open access article under the terms of the Creative Commons Attribution License (CC-BY 4.0), which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited. |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Biomedical Imaging Science Dept (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 20 Jun 2024 09:58 |
Last Modified: | 20 Jun 2024 09:58 |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1002/jmri.28113 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:213679 |