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Changes in kinetic heterogeneity of breast cancer via computer-aided diagnosis on MRI predict the pathological response to neoadjuvant systemic therapy

  • Breast
  • Published:
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Abstract

Objective

To evaluate whether the computer-aided diagnosis (CAD)–extracted kinetic heterogeneity of breast cancer on MRI and changes therein during treatment were associated with the pathological response to neoadjuvant systemic therapy (NST).

Materials and methods

Consecutive patients with invasive breast cancer, who underwent NST followed by surgery between 2014 and 2020, were retrospectively evaluated. Using a commercial CAD system, kinetic features (angiovolume, peak enhancement, delayed enhancement profiles, and kinetic heterogeneity) of breast cancer were assessed with pre- and mid-treatment MRI. Multivariate logistic regression was used to identify the associations between CAD-extracted kinetic features and pathological complete response (pCR).

Results

A total of 130 patients (mean age, 55 years) were included, 37 (28.5%) of whom achieved a pCR. When the pre- and mid-treatment MRI data were compared, the pCR group exhibited greater changes in kinetic heterogeneity (86.14 ± 32.05% vs. 8.50 ± 141.01%, p < 0.001) and angiovolume (95.20 ± 14.29% vs. 19.89 ± 320.16%; p < 0.001) than the non-pCR group. Multivariate regression analysis showed that a large change in kinetic heterogeneity (odds ratio (OR) = 1.030, p < 0.001), age (OR = 0.931, p = 0.005), progesterone receptor negativity (OR = 7.831, p = 0.001), and HER2 positivity (OR = 3.455, p = 0.017) were associated with pCR.

Conclusions

A greater change in the CAD-extracted kinetic heterogeneity of breast cancer between pre- and mid-treatment MRI was associated with a pCR in patients on NST.

Key Points

  • A greater change in kinetic heterogeneity was associated with a pathological complete response.

  • Computer-aided diagnosis–extracted kinetic heterogeneity might serve as a quantitative biomarker of therapeutic efficacy.

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Abbreviations

ADC :

Apparent diffusion coefficient

AUC:

Area under the curve

CAD:

Computer-aided diagnosis

CI:

Confidence interval

DCE:

Dynamic contrast-enhanced

ER:

Estrogen receptor

HER2:

Human epidermal growth factor receptor 2

MRI:

Magnetic resonance imaging

NST:

Neoadjuvant systemic therapy

OR:

Odds ratio

pCR:

Pathological complete response

PR:

Progesterone receptor

ROC:

Receiver operating characteristic

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Funding

This study was supported by an investigator-initiated research grant from Bayer Korea Ltd. The authors had complete control of the data and information submitted for publication at all times and none of the authors are or have been employed by Bayer. The results of the study only belong to the investigator.

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Authors and Affiliations

  1. Department of Radiology, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, 1-10, Ami-Dong, Seo-gu, Busan, 602-739, Republic of Korea

    Lee Hwangbo, Jin You Kim, Jin Joo Kim, Nam Kyung Lee & Suk Kim

Authors
  1. Lee Hwangbo
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  2. Jin You Kim
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  3. Jin Joo Kim
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  4. Nam Kyung Lee
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  5. Suk Kim
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Corresponding author

Correspondence to Jin You Kim.

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Guarantor

The scientific guarantor of this publication is Jin You Kim.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

The study was approved by the institutional review board of Pusan National University Hospital (IRB No. 2012-018-098).

Methodology

• retrospective

• observational

• performed at one institution

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Hwangbo, L., Kim, J.Y., Kim, J.J. et al. Changes in kinetic heterogeneity of breast cancer via computer-aided diagnosis on MRI predict the pathological response to neoadjuvant systemic therapy. Eur Radiol 33, 440–449 (2023). https://doi.org/10.1007/s00330-022-08998-8

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  • DOI: https://doi.org/10.1007/s00330-022-08998-8

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