Breast MRI during Neoadjuvant Chemotherapy: Lack of Background Parenchymal Enhancement Suppression and Inferior Treatment Response
| العنوان: | Breast MRI during Neoadjuvant Chemotherapy: Lack of Background Parenchymal Enhancement Suppression and Inferior Treatment Response |
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| المؤلفون: | Erin P. Crane, An L Church, Dae Hee Bang, Charlotte Dillis, Bethany L. Niell, Angela DeMichele, Marisa H. Borders, Basak E. Dogan, Jennifer S. Drukteinis, Deepa Sheth, Wei Tse Yang, Stefanie Woodard, Mark A. Rosen, Lisa J. Wilmes, Christina Yau, Natsuko Onishi, David C. Newitt, Theresa Kuritza, Jessica Gibbs, Despina Kontos, Marina E. Giurescu, Ella F. Jones, Thomas L. Chenevert, Mohammad Eghtedari, Roy Harnish, Constance D. Lehman, Fredrik Strand, Vignesh A. Arasu, Bruce Porter, Linda Hovanessian-Larsen, Alex Anh-Tu Nguyen, Elise Berman, Hiroyuki Abe, Mary S. Newell, Neda Jafarian, Laura J. Esserman, Savannah C. Partridge, John Kornak, Kelly Fountain, Luminita A. Tudorica, Donald A. Berry, Patrick J Bolan, Michael Nelson, Sally Goudreau, Kathleen M. Ward, Kimberly A. Fitzpatrick, Karen Y. Oh, Bonnie N. Joe, Lara Hardesty, Kevin Morley, Kathleen R. Brandt, Haydee Ojeda-Fournier, Dan Lopez Paniagua, Heidi Umphrey, Elissa R Price, Elizabeth S. McDonald, Wen Li, Pulin Sheth, Dulcy Wolverton, Nola M. Hylton, Kathryn W Zamora |
| المصدر: | Radiology, vol 301, iss 2 |
| بيانات النشر: | Radiological Society of North America (RSNA), 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Adult, Oncology, Aging, medicine.medical_specialty, Treatment response, medicine.medical_treatment, Contrast Media, Breast Neoplasms, Medical and Health Sciences, Cohort Studies, Young Adult, Text mining, Breast cancer, Internal medicine, Breast Cancer, Parenchyma, medicine, Humans, Chemotherapy, Breast MRI, Radiology, Nuclear Medicine and imaging, Breast, skin and connective tissue diseases, Adjuvant, Retrospective Studies, Aged, Cancer, medicine.diagnostic_test, business.industry, Evaluation of treatments and therapeutic interventions, Middle Aged, Image Enhancement, medicine.disease, Magnetic Resonance Imaging, Neoadjuvant Therapy, Nuclear Medicine & Medical Imaging, Treatment Outcome, Chemotherapy, Adjuvant, 6.1 Pharmaceuticals, Biomedical Imaging, Female, business, Hormone |
| الوصف: | Background Suppression of background parenchymal enhancement (BPE) is commonly observed after neoadjuvant chemotherapy (NAC) at contrast-enhanced breast MRI. It was hypothesized that nonsuppressed BPE may be associated with inferior response to NAC. Purpose To investigate the relationship between lack of BPE suppression and pathologic response. Materials and Methods A retrospective review was performed for women with menopausal status data who were treated for breast cancer by one of 10 drug arms (standard NAC with or without experimental agents) between May 2010 and November 2016 in the Investigation of Serial Studies to Predict Your Therapeutic Response with Imaging and Molecular Analysis 2, or I-SPY 2 TRIAL (NCT01042379). Patients underwent MRI at four points: before treatment (T0), early treatment (T1), interregimen (T2), and before surgery (T3). BPE was quantitatively measured by using automated fibroglandular tissue segmentation. To test the hypothesis effectively, a subset of examinations with BPE with high-quality segmentation was selected. BPE change from T0 was defined as suppressed or nonsuppressed for each point. The Fisher exact test and the Z tests of proportions with Yates continuity correction were used to examine the relationship between BPE suppression and pathologic complete response (pCR) in hormone receptor (HR)-positive and HR-negative cohorts. Results A total of 3528 MRI scans from 882 patients (mean age, 48 years ± 10 [standard deviation]) were reviewed and the subset of patients with high-quality BPE segmentation was determined (T1, 433 patients; T2, 396 patients; T3, 380 patients). In the HR-positive cohort, an association between lack of BPE suppression and lower pCR rate was detected at T2 (nonsuppressed vs suppressed, 11.8% [six of 51] vs 28.9% [50 of 173]; difference, 17.1% [95% CI: 4.7, 29.5]; P = .02) and T3 (nonsuppressed vs suppressed, 5.3% [two of 38] vs 27.4% [48 of 175]; difference, 22.2% [95% CI: 10.9, 33.5]; P = .003). In the HR-negative cohort, patients with nonsuppressed BPE had lower estimated pCR rate at all points, but the P values for the association were all greater than .05. Conclusions In hormone receptor-positive breast cancer, lack of background parenchymal enhancement suppression may indicate inferior treatment response. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Philpotts in this issue. |
| وصف الملف: | application/pdf |
| تدمد: | 1527-1315 0033-8419 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e9d4b2fa9b1d86431fe0443e020f3903 https://doi.org/10.1148/radiol.2021203645 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....e9d4b2fa9b1d86431fe0443e020f3903 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15271315 00338419 |
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