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Ultrafast dynamic contrast-enhanced breast MRI: association with pathologic complete response in neoadjuvant treatment of breast cancer

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Abstract

Objectives

The purpose of this study was to investigate whether pretreatment kinetic features from ultrafast DCE-MRI are associated with pathological complete response (pCR) in patients with invasive breast cancer and according to immunohistochemistry (IHC) subtype.

Methods

Between August 2018 and June 2019, 256 consecutive breast cancer patients (mean age, 50.2 years; range, 25–86 years) who underwent both ultrafast and conventional DCE-MRI and surgery following neoadjuvant chemotherapy were included. DCE-MRI kinetic features were obtained from pretreatment MRI data. Time-to-enhancement, maximal slope (MS), and volumes at U1 and U2 (U1, time point at which the lesion starts to enhance; U2, subsequent time point after U1) were derived from ultrafast MRI. Logistic regression analysis was performed to identify factors associated with pCR.

Results

Overall, 41.4% of all patients achieved pCR. None of the kinetic features was associated with pCR when including all cancers. Among ultrafast DCE-MRI kinetic features, a lower MS (OR, 0.982; p = 0.040) was associated with pCR at univariable analysis in hormone receptor (HR)–positive cancers. In triple-negative cancers, a higher volume ratio U1/U2 was associated with pCR at univariable (OR, 11.787; p = 0.006) and multivariable analysis (OR, 14.811; p = 0.005). Among conventional DCE-MRI kinetic features, a lower peak enhancement (OR, 0.993; p = 0.031) and a lower percentage of washout (OR, 0.904; p = 0.039) was associated with pCR only in HR-positive cancers at univariable analysis.

Conclusions

A higher volume ratio of U1/U2 derived from ultrafast DCE-MRI was independently associated with pCR in triple-negative invasive breast cancer.

Key Points

• The ratio of tumor volumes obtained at the first (U1) and second time points (U2) of enhancement was independently associated with pCR in triple-negative invasive breast cancers.

• Ultrafast MRI has the potential to improve accuracy in predicting treatment response and personalizing therapy.

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Abbreviations

CAD:

Computer-aided diagnosis

CI:

Confidence interval

ER:

Estrogen receptor

FOV:

Field of view

HER2:

Human epidermal growth factor receptor type 2

HR:

Hormone receptor

ICC:

Intraclass correlation coefficient

IHC:

Immunohistochemistry

MS:

Maximal slope

NAC:

Neoadjuvant chemotherapy

OR:

Odds ratio

pCR:

Pathological complete response

PR:

Progesterone receptor

TTE:

Time-to-enhancement

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Funding

This study has received funding by a faculty research grant of Yonsei University College of Medicine for 2019 (6–2019-0178) and a Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2017R1D1A1B03035995).

Author information

Authors and Affiliations

  1. Department of Radiology, College of Medicine, CHA Ilsan Medical Center, CHA University, Pocheon, Korea

    Ji Hee Kim

  2. Department of Radiology, College of Medicine, Severance Hospital, Research Institute of Radiological Science, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea

    Vivian Youngjean Park, Min Jung Kim & Jung Hyun Yoon

  3. Department of Biomedical Systems Informatics, Biostatistics Collaboration Unit, College of Medicine, Yonsei University, Seoul, Korea

    Hye Jung Shin

Authors
  1. Ji Hee Kim
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Corresponding author

Correspondence to Vivian Youngjean Park.

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Guarantor

The scientific guarantor of this publication is Vivian Youngjean Park, MD, PhD, Assistant professor of the Department of Radiology, Severance Hospital, Yonsei University, College of Medicine.

Conflict of Interest

The authors declare no competing interests.

Statistics and Biometry

One of the authors (Hye Jung Shin) has significant statistical expertise.

Informed Consent

Written informed consent was waived by the Institutional Review Board.

Ethical Approval

Institutional Review Board approval was obtained.

Methodology

• Retrospective.

• Observational.

• Performed at one institution.

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Kim, J.H., Park, V.Y., Shin, H.J. et al. Ultrafast dynamic contrast-enhanced breast MRI: association with pathologic complete response in neoadjuvant treatment of breast cancer. Eur Radiol 32, 4823–4833 (2022). https://doi.org/10.1007/s00330-021-08530-4

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  • DOI: https://doi.org/10.1007/s00330-021-08530-4

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