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European Radiology
Published in: European Radiology 6/2022

11-01-2022 | Magnetic Resonance Imaging | Breast

Value of diffusion-weighted MRI in predicting early response to neoadjuvant chemotherapy of breast cancer: comparison between ROI-ADC and whole-lesion-ADC measurements

Authors: Nathalie A. Hottat, Dominique A. Badr, Sophie Lecomte, Tatiana Besse-Hammer, Jacques C. Jani, Mieke M. Cannie

Published in: European Radiology | Issue 6/2022

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Abstract

Objective

The aim of the study was to assess DWI with ROI-ADC and WL-ADC measurements in early response after NAC in breast cancer.

Methods

Between January 2016 and December 2019, 55 women were enrolled in this prospective single-center study. MRI was performed at three time points for each patient: before treatment (MRI 1: DW and DCE MRI), after one cycle of NAC (MRI 2: noncontrast DW MRI), and after completion of NAC before surgery (MRI 3: DW and DCE MRI). ROI-ADC and WL-ADC measurements were obtained on MRI and were compared to histology findings and to the RCB class. Patients were categorized as having pCR or non-pCR.

Results

Among 48 patients, 9 experienced pCR. An increase of ROI-ADC between MRI 1 and 2 of more than 47.5% had a sensitivity of 88.9% and a specificity of 63.4% in predicting pCR, whereas WL-ADC did not predict pCR. An increase of ROI-ADC between MRI 1 and 2 of more than 47.5% had a sensitivity of 83.3% and a specificity of 64.9% in predicting radiologic complete response. An increase of WL-ADC between MRI 1 and 2 of more than 25.5% had a sensitivity of 83.3% and a specificity of 75.5% in predicting radiologic complete response.

Conclusion

After one cycle of NAC, a significant increase in breast tumor ROI-ADC at DWI predicted complete pathologic and radiologic responses.

Key Points

• An increase of WL-ADC between MRI 1 and 2 of more than 25.5% had a sensitivity of 83.3% and a specificity of 75.5% in predicting radiologic complete response.
• An increase of ROI-ADC between MRI 1 and 2 of more than 47.5% had a sensitivity of 88.9% and a specificity of 63.4% in predicting pCR, and a sensitivity of 83.3% and a specificity of 64.9% in predicting radiologic complete response.
• A significant increase in breast tumor ROI-ADC at DWI predicted complete pathologic and radiologic responses.
Appendix
Available only for authorised users
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Metadata
Title
Value of diffusion-weighted MRI in predicting early response to neoadjuvant chemotherapy of breast cancer: comparison between ROI-ADC and whole-lesion-ADC measurements
Authors
Nathalie A. Hottat
Dominique A. Badr
Sophie Lecomte
Tatiana Besse-Hammer
Jacques C. Jani
Mieke M. Cannie
Publication date
11-01-2022
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 6/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-021-08462-z

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