Evaluation of pretreatment ADC values as predictors of treatment response to neoadjuvant chemotherapy in patients with breast cancer - a multicenter study
Abstract Background Magnetic resonance imaging (MRI) can be used to diagnose breast cancer. Diffusion weighted imaging (DWI) and the apparent diffusion coefficient (ADC) can reflect tumor microstructure in a non-invasive manner. The correct prediction of response of neoadjuvant chemotherapy (NAC) is...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-12-01
|
| Series: | Cancer Imaging |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40644-022-00501-2 |
| _version_ | 1811301828616257536 |
|---|---|
| author | Alexey Surov Maciej Pech Hans-Jonas Meyer Almir G. V. Bitencourt Hiroshi Fujimoto Gabrielle C. Baxter Gorane Santamaría Fiona J. Gilbert Andreas Wienke |
| author_facet | Alexey Surov Maciej Pech Hans-Jonas Meyer Almir G. V. Bitencourt Hiroshi Fujimoto Gabrielle C. Baxter Gorane Santamaría Fiona J. Gilbert Andreas Wienke |
| author_sort | Alexey Surov |
| collection | DOAJ |
| description | Abstract Background Magnetic resonance imaging (MRI) can be used to diagnose breast cancer. Diffusion weighted imaging (DWI) and the apparent diffusion coefficient (ADC) can reflect tumor microstructure in a non-invasive manner. The correct prediction of response of neoadjuvant chemotherapy (NAC) is crucial for clinical routine. Our aim was to compare ADC values between patients with pathological complete response (pCR) and non-responders based upon a multi-center design to improve the correct patient selection, which patient would more benefit from NAC and which patient would not. Methods For this study, data from 4 centers (from Japan, Brazil, Spain and United Kingdom) were retrospectively acquired. The time period was overall 2003–2019. The patient sample comprises 250 patients (all female; median age, 50.5). In every case, pretreatment breast MRI with DWI was performed. pCR was assessed by experienced pathologists in every center using the surgical specimen in the clinical routine work up. pCR was defined as no residual invasive disease in either breast or axillary lymph nodes after NAC. ADC values between the group with pCR and those with no pCR were compared using the Mann–Whitney U test (two-group comparisons). Univariable and multivariabe logistic regression analysis was performed to predict pCR status. Results Overall, 83 patients (33.2%) achieved pCR. The ADC values of the patient group with pCR were lower compared with patients without pCR (0.98 ± 0.23 × 10− 3 mm2/s versus 1.07 ± 0.24 × 10− 3 mm2/s, p = 0.02). The ADC value achieved an odds ratio of 4.65 (95% CI 1.40–15.49) in univariable analysis and of 3.0 (95% CI 0.85–10.63) in multivariable analysis (overall sample) to be associated with pCR status. The odds ratios differed in the subgroup analyses in accordance with the molecular subtype. Conclusions The pretreatment ADC-value is associated with pathological complete response after NAC in breast cancer patients. This could aid in clinical routine to reduce treatment toxicity for patients, who would not benefit from NAC. However, this must be tested in further studies, as the overlap of the ADC values in both groups is too high for clinical prediction. |
| first_indexed | 2024-04-13T07:15:48Z |
| format | Article |
| id | doaj.art-92d34ae7bf914fb6b45633f1eb9c6e13 |
| institution | Directory Open Access Journal |
| issn | 1470-7330 |
| language | English |
| last_indexed | 2024-04-13T07:15:48Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Cancer Imaging |
| spelling | doaj.art-92d34ae7bf914fb6b45633f1eb9c6e132022-12-22T02:56:45ZengBMCCancer Imaging1470-73302022-12-012211810.1186/s40644-022-00501-2Evaluation of pretreatment ADC values as predictors of treatment response to neoadjuvant chemotherapy in patients with breast cancer - a multicenter studyAlexey Surov0Maciej Pech1Hans-Jonas Meyer2Almir G. V. Bitencourt3Hiroshi Fujimoto4Gabrielle C. Baxter5Gorane Santamaría6Fiona J. Gilbert7Andreas Wienke8Department of Radiology and Nuclear Medicine, Otto von Guericke UniversityDepartment of Radiology and Nuclear Medicine, Otto von Guericke UniversityDepartment of Diagnostic and Interventional Radiology, University of LeipzigDepartment of Imaging – A.C.Camargo Cancer CenterDepartment of General Surgery, Chiba University Graduate, School of MedicineDepartment of Radiology, School of Clinical Medicine, University of CambridgeDepartments of Radiology, Hospital Clínic de Barcelona, University of Barcelona Medical SchoolDepartment of Radiology, School of Clinical Medicine, University of CambridgeInstitute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-WittenbergAbstract Background Magnetic resonance imaging (MRI) can be used to diagnose breast cancer. Diffusion weighted imaging (DWI) and the apparent diffusion coefficient (ADC) can reflect tumor microstructure in a non-invasive manner. The correct prediction of response of neoadjuvant chemotherapy (NAC) is crucial for clinical routine. Our aim was to compare ADC values between patients with pathological complete response (pCR) and non-responders based upon a multi-center design to improve the correct patient selection, which patient would more benefit from NAC and which patient would not. Methods For this study, data from 4 centers (from Japan, Brazil, Spain and United Kingdom) were retrospectively acquired. The time period was overall 2003–2019. The patient sample comprises 250 patients (all female; median age, 50.5). In every case, pretreatment breast MRI with DWI was performed. pCR was assessed by experienced pathologists in every center using the surgical specimen in the clinical routine work up. pCR was defined as no residual invasive disease in either breast or axillary lymph nodes after NAC. ADC values between the group with pCR and those with no pCR were compared using the Mann–Whitney U test (two-group comparisons). Univariable and multivariabe logistic regression analysis was performed to predict pCR status. Results Overall, 83 patients (33.2%) achieved pCR. The ADC values of the patient group with pCR were lower compared with patients without pCR (0.98 ± 0.23 × 10− 3 mm2/s versus 1.07 ± 0.24 × 10− 3 mm2/s, p = 0.02). The ADC value achieved an odds ratio of 4.65 (95% CI 1.40–15.49) in univariable analysis and of 3.0 (95% CI 0.85–10.63) in multivariable analysis (overall sample) to be associated with pCR status. The odds ratios differed in the subgroup analyses in accordance with the molecular subtype. Conclusions The pretreatment ADC-value is associated with pathological complete response after NAC in breast cancer patients. This could aid in clinical routine to reduce treatment toxicity for patients, who would not benefit from NAC. However, this must be tested in further studies, as the overlap of the ADC values in both groups is too high for clinical prediction.https://doi.org/10.1186/s40644-022-00501-2Breast cancerDWIADCNeoadjuvant treatment |
| spellingShingle | Alexey Surov Maciej Pech Hans-Jonas Meyer Almir G. V. Bitencourt Hiroshi Fujimoto Gabrielle C. Baxter Gorane Santamaría Fiona J. Gilbert Andreas Wienke Evaluation of pretreatment ADC values as predictors of treatment response to neoadjuvant chemotherapy in patients with breast cancer - a multicenter study Cancer Imaging Breast cancer DWI ADC Neoadjuvant treatment |
| title | Evaluation of pretreatment ADC values as predictors of treatment response to neoadjuvant chemotherapy in patients with breast cancer - a multicenter study |
| title_full | Evaluation of pretreatment ADC values as predictors of treatment response to neoadjuvant chemotherapy in patients with breast cancer - a multicenter study |
| title_fullStr | Evaluation of pretreatment ADC values as predictors of treatment response to neoadjuvant chemotherapy in patients with breast cancer - a multicenter study |
| title_full_unstemmed | Evaluation of pretreatment ADC values as predictors of treatment response to neoadjuvant chemotherapy in patients with breast cancer - a multicenter study |
| title_short | Evaluation of pretreatment ADC values as predictors of treatment response to neoadjuvant chemotherapy in patients with breast cancer - a multicenter study |
| title_sort | evaluation of pretreatment adc values as predictors of treatment response to neoadjuvant chemotherapy in patients with breast cancer a multicenter study |
| topic | Breast cancer DWI ADC Neoadjuvant treatment |
| url | https://doi.org/10.1186/s40644-022-00501-2 |
| work_keys_str_mv | AT alexeysurov evaluationofpretreatmentadcvaluesaspredictorsoftreatmentresponsetoneoadjuvantchemotherapyinpatientswithbreastcanceramulticenterstudy AT maciejpech evaluationofpretreatmentadcvaluesaspredictorsoftreatmentresponsetoneoadjuvantchemotherapyinpatientswithbreastcanceramulticenterstudy AT hansjonasmeyer evaluationofpretreatmentadcvaluesaspredictorsoftreatmentresponsetoneoadjuvantchemotherapyinpatientswithbreastcanceramulticenterstudy AT almirgvbitencourt evaluationofpretreatmentadcvaluesaspredictorsoftreatmentresponsetoneoadjuvantchemotherapyinpatientswithbreastcanceramulticenterstudy AT hiroshifujimoto evaluationofpretreatmentadcvaluesaspredictorsoftreatmentresponsetoneoadjuvantchemotherapyinpatientswithbreastcanceramulticenterstudy AT gabriellecbaxter evaluationofpretreatmentadcvaluesaspredictorsoftreatmentresponsetoneoadjuvantchemotherapyinpatientswithbreastcanceramulticenterstudy AT goranesantamaria evaluationofpretreatmentadcvaluesaspredictorsoftreatmentresponsetoneoadjuvantchemotherapyinpatientswithbreastcanceramulticenterstudy AT fionajgilbert evaluationofpretreatmentadcvaluesaspredictorsoftreatmentresponsetoneoadjuvantchemotherapyinpatientswithbreastcanceramulticenterstudy AT andreaswienke evaluationofpretreatmentadcvaluesaspredictorsoftreatmentresponsetoneoadjuvantchemotherapyinpatientswithbreastcanceramulticenterstudy |