Yunju Kim1, Sung Hun Kim2, Hye Won Lee3, Byung Joo Song4, Bong Joo Kang5, Ahwon Lee3, Yoonho Nam5. 1. Department of Radiology, National Cancer Center, Goyang, Gyeonggi 10408, Republic of Korea. 2. Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul 06591, Republic of Korea. Electronic address: rad-ksh@catholic.ac.kr. 3. Department of Pathology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul 06591, Republic of Korea. 4. Department of Surgery, College of Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, Gyeonggi 14647, Republic of Korea. 5. Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Abstract
PURPOSE: To determine the diagnostic performance of intravoxel incoherent motion (IVIM) diffusion-weighted (DW) magnetic resonance imaging (MRI) parameters in predicting response to neoadjuvant chemotherapy (NAC) in breast cancer patients. MATERIALS AND METHODS: Forty-six patients with stage II or III breast cancer underwent MRI including DW imaging with 10 b values before and after 2cycles of NAC. Apparent diffusion coefficient (ADC) and IVIM parameters (D, D*, and f) were obtained using histogram analysis derived from whole-tumor volumes. After surgery, imaging parameters were compared with histopathologic responses using the Miller-Payne grading system. RESULTS: Before NAC, Dmean, D50, and D75 were higher in good responders than in minor responders (P≤0.043). After NAC, ADCmean, ADC50, ADC75, Dmean, D25, D50, and D75 were higher in good responders (P≤0.037). Skewness of ADC and D were lower in good responders after NAC (P≤0.005). Most histogram metrics of posttreatment ADC and D had similar AUC values with reasonable accuracy for prediction of good response (AUC≥0.7, P<0.05). CONCLUSION: D and ADC are useful for the prediction of response to NAC in breast cancer patients. Additional information is obtained by application of the IVIM model in DW imaging analysis and histogram analysis using whole-tumor volume data.
PURPOSE: To determine the diagnostic performance of intravoxel incoherent motion (IVIM) diffusion-weighted (DW) magnetic resonance imaging (MRI) parameters in predicting response to neoadjuvant chemotherapy (NAC) in breast cancerpatients. MATERIALS AND METHODS: Forty-six patients with stage II or III breast cancer underwent MRI including DW imaging with 10 b values before and after 2cycles of NAC. Apparent diffusion coefficient (ADC) and IVIM parameters (D, D*, and f) were obtained using histogram analysis derived from whole-tumor volumes. After surgery, imaging parameters were compared with histopathologic responses using the Miller-Payne grading system. RESULTS: Before NAC, Dmean, D50, and D75 were higher in good responders than in minor responders (P≤0.043). After NAC, ADCmean, ADC50, ADC75, Dmean, D25, D50, and D75 were higher in good responders (P≤0.037). Skewness of ADC and D were lower in good responders after NAC (P≤0.005). Most histogram metrics of posttreatment ADC and D had similar AUC values with reasonable accuracy for prediction of good response (AUC≥0.7, P<0.05). CONCLUSION: D and ADC are useful for the prediction of response to NAC in breast cancerpatients. Additional information is obtained by application of the IVIM model in DW imaging analysis and histogram analysis using whole-tumor volume data.
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