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Breast

Prognostic value of pretreatment dynamic contrast-enhanced MR imaging in breast cancer patients receiving neoadjuvant chemotherapy: overall survival predicted from combined time course and volume analysis

, , , , , & show all
Pages 604-612 | Accepted 16 Mar 2010, Published online: 30 Apr 2010
 

Abstract

Background: The prognostic value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in breast cancer has been explored, and the results are promising.

Purpose: To investigate the possible correlation between pretreatment DCE-MRI and overall survival 5 years after diagnosis in breast cancer patients receiving neoadjuvant chemotherapy (NAC) using combined time course analysis and volume measurement from DCE-MRI data acquired with 1 min temporal resolution.

Material and Methods: Pretreatment DCE-MR images of 32 female patients were examined. The total enhancing volume was calculated by including the voxels with >60% signal enhancing 1 min postcontrast. The signal intensity time course data were automatically classified on a voxel-by-voxel basis according to the enhancing characteristics: persistent (type I), plateau (type II) or washout (type III), and the resulting volumes of each enhancement type were calculated.

Results: A significant correlation between total enhancing volume and 5-year survival was found, P=0.05 (log-rank). The survival was 51 ±15 months (mean ±95% confidence intervals (CI)) and 73±12 months in patients with a total enhancing volume >41 cm3 and ≤41 cm3, respectively. A two-dimensional discriminator, taking both total enhancing volume and type III enhancing volume into account, improved the prediction of survival, resulting in a P value (log-rank) between survivors and non-survivors of <0.001. The survival was 44±16 months (mean ±95% CI) and 74±11 months in patients with a total enhancing volume >58 cm3 and/or a type III volume >8 cm3, and ≤58 cm3 and ≤8 cm3, respectively.

Conclusion: Pretreatment DCE-MRI might help in predicting prognosis in breast cancer patients receiving NAC.

Acknowledgment

We would like to thank the Norwegian Women's Public Health Association, Trondheim, for their generous financial contribution.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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