Kinetic information from dynamic contrast-enhanced MRI enables prediction of residual cancer burden and prognosis in triple-negative breast cancer: a retrospective study

• Published in: Scientific reports Vol. 11; no. 1; pp. 10112 - 11
• Main Authors: Yamaguchi, Ayane, Honda, Maya, Ishiguro, Hiroshi, Kataoka, Masako, Kataoka, Tatsuki R., Shimizu, Hanako, Torii, Masae, Mori, Yukiko, Kawaguchi-Sakita, Nobuko, Ueno, Kentaro, Kawashima, Masahiro, Takada, Masahiro, Suzuki, Eiji, Nakamoto, Yuji, Kawaguchi, Kosuke, Toi, Masakazu
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 12.05.2021; Nature Publishing Group; Nature Portfolio
• Subjects: 631/67; 631/67/1347; Breast cancer; Chemotherapy; Humanities and Social Sciences; Lesions; Magnetic resonance imaging; Medical prognosis; multidisciplinary; Prognosis; Remission; Science; Science (multidisciplinary); Tumors
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-89380-4

This study aimed to evaluate the predictions of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for prognosis of triple-negative breast cancer (TNBC), especially with residual disease (RD) after preoperative chemotherapy. This retrospective analysis included 74 TNBC patients who received preoperative chemotherapy. DCE-MRI findings from three timepoints were examined: at diagnosis (MRI pre ), at midpoint (MRI mid ) and after chemotherapy (MRI post ). These findings included cancer lesion size, washout index (WI) as a kinetic parameter using the difference in signal intensity between early and delayed phases, and time-signal intensity curve types. Distant disease-free survival was analysed using the log-rank test to compare RD group with and without a fast-washout curve. The diagnostic performance of DCE-MRI findings, including positive predictive value (PPV) for pathological responses, was also calculated. RD without fast washout curve was a significantly better prognostic factor, both at MRI mid and MRI post (hazard ratio = 0.092, 0.098, p < 0.05). PPV for pathological complete remission at MRI mid was 76.7% by the cut-off point at negative WI value or lesion size = 0, and 66.7% at lesion size = 0. WI and curve types derived from DCE-MRI at the midpoint of preoperative chemotherapy can help not only assess tumour response but also predict prognosis.