Impact of Alternate <i>b</i>-Value Combinations and Metrics on the Predictive Performance and Repeatability of Diffusion-Weighted MRI in Breast Cancer Treatment: Results from the ECOG-ACRIN A6698 Trial
In diffusion-weighted MRI (DW-MRI), choice of <i>b</i>-value influences apparent diffusion coefficient (ADC) values by probing different aspects of the tissue microenvironment. As a secondary analysis of the multicenter ECOG-ACRIN A6698 trial, the purpose of this study was to investigate...
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| Format: | Article |
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MDPI AG
2022-03-01
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| Series: | Tomography |
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| Online Access: | https://www.mdpi.com/2379-139X/8/2/58 |
| _version_ | 1797409179849195520 |
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| author | Savannah C. Partridge Jon Steingrimsson David C. Newitt Jessica E. Gibbs Helga S. Marques Patrick J. Bolan Michael A. Boss Thomas L. Chenevert Mark A. Rosen Nola M. Hylton |
| author_facet | Savannah C. Partridge Jon Steingrimsson David C. Newitt Jessica E. Gibbs Helga S. Marques Patrick J. Bolan Michael A. Boss Thomas L. Chenevert Mark A. Rosen Nola M. Hylton |
| author_sort | Savannah C. Partridge |
| collection | DOAJ |
| description | In diffusion-weighted MRI (DW-MRI), choice of <i>b</i>-value influences apparent diffusion coefficient (ADC) values by probing different aspects of the tissue microenvironment. As a secondary analysis of the multicenter ECOG-ACRIN A6698 trial, the purpose of this study was to investigate the impact of alternate <i>b</i>-value combinations on the performance and repeatability of tumor ADC as a predictive marker of breast cancer treatment response. The final analysis included 210 women who underwent standardized 4-<i>b</i>-value DW-MRI (<i>b</i> = 0/100/600/800 s/mm<sup>2</sup>) at multiple timepoints during neoadjuvant chemotherapy treatment and a subset (n = 71) who underwent test–retest scans. Centralized tumor ADC and perfusion fraction (<i>f<sub>p</sub></i>) measures were performed using variable <i>b</i>-value combinations. Prediction of pathologic complete response (pCR) based on the mid-treatment/12-week percent change in each metric was estimated by area under the receiver operating characteristic curve (AUC). Repeatability was estimated by within-subject coefficient of variation (wCV). Results show that two-<i>b</i>-value ADC calculations provided non-inferior predictive value to four-<i>b</i>-value ADC calculations overall (AUCs = 0.60–0.61 versus AUC = 0.60) and for HR+/HER2− cancers where ADC was most predictive (AUCs = 0.75–0.78 versus AUC = 0.76), <i>p</i> < 0.05. Using two <i>b</i>-values (0/600 or 0/800 s/mm<sup>2</sup>) did not reduce ADC repeatability over the four-<i>b</i>-value calculation (wCVs = 4.9–5.2% versus 5.4%). The alternate metrics ADC<sub>fast</sub> (<i>b</i> ≤ 100 s/mm<sup>2</sup>), ADC<sub>slow</sub> (<i>b</i> ≥ 100 s/mm<sup>2</sup>), and <i>f<sub>p</sub></i> did not improve predictive performance (AUCs = 0.54–0.60, <i>p</i> = 0.08–0.81), and ADC<sub>fast</sub> and <i>f<sub>p</sub></i> demonstrated the lowest repeatability (wCVs = 6.71% and 12.4%, respectively). In conclusion, breast tumor ADC calculated using a simple two-<i>b</i>-value approach can provide comparable predictive value and repeatability to full four-<i>b</i>-value measurements as a marker of treatment response. |
| first_indexed | 2024-03-09T04:10:37Z |
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| language | English |
| last_indexed | 2024-03-09T04:10:37Z |
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| spelling | doaj.art-5c5a779cb97d4e7db7ebdf78c0bc4d922023-12-03T14:01:09ZengMDPI AGTomography2379-13812379-139X2022-03-018270171710.3390/tomography8020058Impact of Alternate <i>b</i>-Value Combinations and Metrics on the Predictive Performance and Repeatability of Diffusion-Weighted MRI in Breast Cancer Treatment: Results from the ECOG-ACRIN A6698 TrialSavannah C. Partridge0Jon Steingrimsson1David C. Newitt2Jessica E. Gibbs3Helga S. Marques4Patrick J. Bolan5Michael A. Boss6Thomas L. Chenevert7Mark A. Rosen8Nola M. Hylton9Department of Radiology, University of Washington, Seattle, WA 98195, USADepartment of Biostatistics and Center for Statistical Sciences, Brown University, Providence, RI 02912, USADepartment of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94143, USADepartment of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94143, USADepartment of Biostatistics and Center for Statistical Sciences, Brown University, Providence, RI 02912, USACenter for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN 55455, USACenter for Research and Innovation, American College of Radiology, Philadelphia, PA 19103, USAUniversity of Michigan, Ann Arbor, MI 48109, USAUniversity of Pennsylvania, Philadelphia, PA 19104, USADepartment of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94143, USAIn diffusion-weighted MRI (DW-MRI), choice of <i>b</i>-value influences apparent diffusion coefficient (ADC) values by probing different aspects of the tissue microenvironment. As a secondary analysis of the multicenter ECOG-ACRIN A6698 trial, the purpose of this study was to investigate the impact of alternate <i>b</i>-value combinations on the performance and repeatability of tumor ADC as a predictive marker of breast cancer treatment response. The final analysis included 210 women who underwent standardized 4-<i>b</i>-value DW-MRI (<i>b</i> = 0/100/600/800 s/mm<sup>2</sup>) at multiple timepoints during neoadjuvant chemotherapy treatment and a subset (n = 71) who underwent test–retest scans. Centralized tumor ADC and perfusion fraction (<i>f<sub>p</sub></i>) measures were performed using variable <i>b</i>-value combinations. Prediction of pathologic complete response (pCR) based on the mid-treatment/12-week percent change in each metric was estimated by area under the receiver operating characteristic curve (AUC). Repeatability was estimated by within-subject coefficient of variation (wCV). Results show that two-<i>b</i>-value ADC calculations provided non-inferior predictive value to four-<i>b</i>-value ADC calculations overall (AUCs = 0.60–0.61 versus AUC = 0.60) and for HR+/HER2− cancers where ADC was most predictive (AUCs = 0.75–0.78 versus AUC = 0.76), <i>p</i> < 0.05. Using two <i>b</i>-values (0/600 or 0/800 s/mm<sup>2</sup>) did not reduce ADC repeatability over the four-<i>b</i>-value calculation (wCVs = 4.9–5.2% versus 5.4%). The alternate metrics ADC<sub>fast</sub> (<i>b</i> ≤ 100 s/mm<sup>2</sup>), ADC<sub>slow</sub> (<i>b</i> ≥ 100 s/mm<sup>2</sup>), and <i>f<sub>p</sub></i> did not improve predictive performance (AUCs = 0.54–0.60, <i>p</i> = 0.08–0.81), and ADC<sub>fast</sub> and <i>f<sub>p</sub></i> demonstrated the lowest repeatability (wCVs = 6.71% and 12.4%, respectively). In conclusion, breast tumor ADC calculated using a simple two-<i>b</i>-value approach can provide comparable predictive value and repeatability to full four-<i>b</i>-value measurements as a marker of treatment response.https://www.mdpi.com/2379-139X/8/2/58breast cancerdiffusion-weighted MRI (DW-MRI)apparent diffusion coefficient (ADC)treatment responserepeatabilityreproducibility |
| spellingShingle | Savannah C. Partridge Jon Steingrimsson David C. Newitt Jessica E. Gibbs Helga S. Marques Patrick J. Bolan Michael A. Boss Thomas L. Chenevert Mark A. Rosen Nola M. Hylton Impact of Alternate <i>b</i>-Value Combinations and Metrics on the Predictive Performance and Repeatability of Diffusion-Weighted MRI in Breast Cancer Treatment: Results from the ECOG-ACRIN A6698 Trial Tomography breast cancer diffusion-weighted MRI (DW-MRI) apparent diffusion coefficient (ADC) treatment response repeatability reproducibility |
| title | Impact of Alternate <i>b</i>-Value Combinations and Metrics on the Predictive Performance and Repeatability of Diffusion-Weighted MRI in Breast Cancer Treatment: Results from the ECOG-ACRIN A6698 Trial |
| title_full | Impact of Alternate <i>b</i>-Value Combinations and Metrics on the Predictive Performance and Repeatability of Diffusion-Weighted MRI in Breast Cancer Treatment: Results from the ECOG-ACRIN A6698 Trial |
| title_fullStr | Impact of Alternate <i>b</i>-Value Combinations and Metrics on the Predictive Performance and Repeatability of Diffusion-Weighted MRI in Breast Cancer Treatment: Results from the ECOG-ACRIN A6698 Trial |
| title_full_unstemmed | Impact of Alternate <i>b</i>-Value Combinations and Metrics on the Predictive Performance and Repeatability of Diffusion-Weighted MRI in Breast Cancer Treatment: Results from the ECOG-ACRIN A6698 Trial |
| title_short | Impact of Alternate <i>b</i>-Value Combinations and Metrics on the Predictive Performance and Repeatability of Diffusion-Weighted MRI in Breast Cancer Treatment: Results from the ECOG-ACRIN A6698 Trial |
| title_sort | impact of alternate i b i value combinations and metrics on the predictive performance and repeatability of diffusion weighted mri in breast cancer treatment results from the ecog acrin a6698 trial |
| topic | breast cancer diffusion-weighted MRI (DW-MRI) apparent diffusion coefficient (ADC) treatment response repeatability reproducibility |
| url | https://www.mdpi.com/2379-139X/8/2/58 |
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