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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

2010; SAGE Publishing; Volume: 51; Issue: 6 Linguagem: Inglês

10.3109/02841851003782059

1600-0455

Mariann Gjervik Heldahl, Tone F. Bathen, Jana Rydland, Kjell Arne Kvistad, Steinar Lundgren, Ingrid S. Gribbestad, Pål Erik Goa,

Breast Lesions and Carcinomas

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 cm 3 and ≤41 cm 3 , 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 cm 3 and/or a type III volume >8 cm 3 , and ≤58 cm 3 and ≤8 cm 3 , respectively. Conclusion: Pretreatment DCE-MRI might help in predicting prognosis in breast cancer patients receiving NAC.