Dataset Information

Towards detection of early response in neoadjuvant chemotherapy of breast cancer using Bayesian intravoxel incoherent motion.

ABSTRACT:

Introduction

The early identification of good responders to neoadjuvant chemotherapy (NACT) holds a significant potential in the optimal treatment of breast cancer. A recent Bayesian approach has been postulated to improve the accuracy of the intravoxel incoherent motion (IVIM) model for clinical translation. This study examined the prediction and early sensitivity of Bayesian IVIM to NACT response.

Materials and methods

Seventeen female patients with breast cancer were scanned at baseline and 16 patients were scanned after Cycle 1. Tissue diffusion and perfusion from Bayesian IVIM were calculated at baseline with percentage change at Cycle 1 computed with reference to baseline. Cellular proliferative activity marker Ki-67 was obtained semi-quantitatively with percentage change at excision computed with reference to core biopsy.

Results

The perfusion fraction showed a significant difference (p = 0.042) in percentage change between responder groups at Cycle 1, with a decrease in good responders [-7.98% (-19.47-1.73), n = 7] and an increase in poor responders [10.04% (5.09-28.93), n = 9]. There was a significant correlation between percentage change in perfusion fraction and percentage change in Ki-67 (p = 0.042). Tissue diffusion and pseudodiffusion showed no significant difference in percentage change between groups at Cycle 1, nor was there a significant correlation against percentage change in Ki-67. Perfusion fraction, tissue diffusion, and pseudodiffusion showed no significant difference between groups at baseline, nor was there a significant correlation against Ki-67 from core biopsy.

Conclusion

The alteration in tumour perfusion fraction from the Bayesian IVIM model, in association with cellular proliferation, showed early sensitivity to good responders in NACT.

Clinical trial registration

https://clinicaltrials.gov/ct2/show/NCT03501394, identifier NCT03501394.

SUBMITTER: Cheung SM

PROVIDER: S-EPMC10731248 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

Towards detection of early response in neoadjuvant chemotherapy of breast cancer using Bayesian intravoxel incoherent motion.

Cheung Sai Man SM Wu Wing-Shan WS Senn Nicholas N Sharma Ravi R McGoldrick Trevor T Gagliardi Tanja T Husain Ehab E Masannat Yazan Y He Jiabao J

Frontiers in oncology 20231206

<h4>Introduction</h4>The early identification of good responders to neoadjuvant chemotherapy (NACT) holds a significant potential in the optimal treatment of breast cancer. A recent Bayesian approach has been postulated to improve the accuracy of the intravoxel incoherent motion (IVIM) model for clinical translation. This study examined the prediction and early sensitivity of Bayesian IVIM to NACT response.<h4>Materials and methods</h4>Seventeen female patients with breast cancer were scanned at ...[more]

PMID: 38125950

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Project description:The aim of the study was to prospectively evaluate the clinical value of intravoxel incoherent motion (IVIM)-magnetic resonance imaging (MRI) in early predicting the treatment response to neoadjuvant chemotherapy (NAC) for nasopharyngeal carcinoma (NPC). Forty-eight patients with locoregionally advanced NPC were imaged with IVIM-MRI (14 b-factors, 0-1000 s/mm2) on a 3.0-T Magnetic resonance system, at the baseline, and repeatedly at the third and 21st day after NAC started. The IVIM-derived parameters (D*, pure diffusion coefficient; f, perfusion fraction; and D, pseudodiffusion coefficient) were calculated with the Interactive Data Language version 6.3 software. The baseline parameters and their corresponding changes (Δparameter(day)) during NAC were compared using the Student t test or Mann-Whitney U test. Variation analyses of IVIM-derived parameters were tested with intraclass correlation coefficient. Receiver-operating characteristic (ROC) curve analysis was conducted to estimate the best diagnostic accuracy. Statistical analyses were performed on the SPSS 18.0 software, with a 2-tailed probability value, P < 0.05 was considered significant. Among recruited patients, 37 cases were categorized as responders and 11 cases as nonresponders after NAC completed. The intra- and interobserver intraclass correlation coefficient of IVIM-derived parameters were excellent, which ranged from 0.858 to 0.971. Compared with the baseline value, at the third and 21st day, the D value was significantly higher and the D* value significantly lower (P < 0.05, P < 0.001, respectively). In contrast, f parameter only changed slightly (P > 0.05). Compared with nonresponders, responders presented a notably lower baseline D value and higher ΔD3, ΔD21, ΔD3*, ΔD21*, and Δf21 (P < 0.05), but no significant change in Δf3 was observed (P > 0.1). The receiver-operating characteristic curve analyses indicated that the threshold of baseline D values that best predicted the responders for primary nasopharynx tumors and metastatic lymph nodes were 0.911 × 10(-3) mm2/s versus 0.951 × 10(-3) mm2/s, and their corresponding area under curve, sensitivity, and specificity were 0.714 versus 0.774, 0.658 versus 0.538, and 0.818 versus 0.944, respectively. IVIM-MRI can potentially early predict the treatment response of NAC for NPC patients. The baseline D value, and early changes in D and D value are better predictors of the chemotherapeutic responsiveness.

Project description:BackgroundTo explore the value of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in the early assessment of colorectal cancer liver metastases (CRLM).MethodsA total of 34 patients with pathologically confirmed unresectable CRLM were enrolled. All participants uniformly received capecitabine and oxaliplatin (CAPOX) plus bevacizumab chemotherapy as standard first-line treatment for advanced colorectal cancer (CRC). Participants underwent 1.5-T conventional magnetic resonance imaging (MRI) and IVIM-DWI sequence scans with 9 b values (0 to 1,000 s/mm2) before treatment and at 3 weeks of treatment, and conventional MRI scans were performed at 6 and 12 weeks after the initial treatment. The IVIM-DWI parameters in the tumor target area were extracted using image post-processing software, including perfusion fraction (f), true diffusion coefficient (D), and false diffusion coefficient (D*). The response assessment was based on the Response Evaluation Criteria in Solid Tumors (RECIST) v. 1.1 by measuring the longest tumor diameter on dynamic contrast-enhanced (DCE) T1-weighted images.ResultsAccording to the RECIST v. 1.1 criteria, the 34 participants were divided into a response group (n=16) and a non-response group (n=18). In the response group, the f value was significantly lowered (P=0.001) and the D value was significantly increased after treatment (P=0.002). In the non-response group, the D value was increased slightly after treatment (P=0.039), and there was no significant difference in the f value and the D* value. In addition, the f value at baseline was significantly greater in the response group than in the non-response group (0.221±0.033 vs. 0.175±0.040; P=0.001). The receiver operating characteristic (ROC) curve analysis showed that the percentage change of the f value obtained the largest area under the curve (AUC =0.797), and the AUC obtained by the Fisher's linear discriminant analysis (FLDA) method (Δf & ΔD combination) was 0.819.ConclusionsThe IVIM-DWI parameters (f values and D values) provided effective assessment of the therapeutic effect of CAPOX combined with bevacizumab in patients with CRLM at an early stage, and the f value of the pre-treatment tumor area was shown to be useful for predicting the treatment response of patients.

Project description:BackgroundThe spleen is a frequent organ of leukemia metastasis. This study aimed to investigate the value of intravoxel incoherent motion (IVIM) diffusion-weighted magnetic resonance imaging (MRI) for assessing pathologic changes in the spleen and identifying early spleen involvement in patients with acute leukemia (AL).MethodsPatients with newly diagnosed AL and healthy controls were recruited between June 2020 and November 2022. All participants underwent abdominal IVIM diffusion-weighted imaging (DWI) at our hospital. IVIM parameters [pure diffusion coefficient (D); pseudo-diffusion coefficient (D*); and pseudo-perfusion fraction (f)] of the spleen were calculated by the segmented fitting method, and perfusion-diffusion ratio (PDR) was further calculated from the values of D, D* and f. Spleen volumes (SVs) were obtained by manually segmenting the spleen layer by layer. Clinical biomarkers of AL patients were collected. Patients were divided into splenomegaly group and normal SV group according to the individualized reference intervals for SV. IVIM parameters were compared among the control group, AL with normal SV group, and AL with splenomegaly group using one-way analysis of variance, followed by pairwise post hoc comparisons. The correlations of IVIM parameters with clinical biomarkers were analyzed in AL patients. The diagnostic performances of IVIM parameters and their combinations for differentiating among the three groups were compared.ResultsSeventy-nine AL patients (AL with splenomegaly: n=54; AL with normal SV: n=25) and 55 healthy controls were evaluated. IVIM parameters were significantly different among the three groups (P<0.001 for D, D* and f; P=0.001 for PDR). D and PDR showed significant differences between the control and AL with normal SV groups in pairwise comparisons (P<0.001, and P=0.031, respectively). D was correlated with white blood cell (WBC) counts (r=-0.424; 95% CI: -0.570, -0.211; P<0.001), lactate dehydrogenase (LDH) (r=-0.285; 95% CI: -0.486, -0.011; P=0.011), and bone marrow blasts (r=-0.283; 95% CI: -0.476, -0.067; P=0.012). D* (r=-0.276; 95% CI: -0.470, -0.025; P=0.014), f (r=0.514; 95% CI: 0.342, 0.664; P<0.001) and PDR (r=0.343; 95% CI: 0.208, 0.549; P=0.002) were correlated with LDH. The combination of IVIM parameters (AUC: 0.830; 95% CI: 0.729, 0.905) demonstrated better diagnostic efficacy than the single D* (AUC: 0.721; 95% CI: 0.608, 0.816; Delong test: Z=2.012, P=0.044) and f (AUC: 0.647; 95% CI: 0.532, 0.752; Delong test: Z=2.829, P=0.005), but was not significantly different from the single D (AUC: 0.756; 95% CI: 0.647, 0.846; Delong test: Z=1.676, P=0.094) in differentiating the splenomegaly group and normal SV group.ConclusionsIVIM diffusion-weighted MRI could be a potential alternative for assessing pathologic changes in the spleen from cellularity and angiogenesis, and D and PDR may be viable indicators to identify early spleen involvement in patients with AL.

Dataset Information

Towards detection of early response in neoadjuvant chemotherapy of breast cancer using Bayesian intravoxel incoherent motion.

Introduction

Materials and methods

Results

Conclusion

Clinical trial registration

Publications

Towards detection of early response in neoadjuvant chemotherapy of breast cancer using Bayesian intravoxel incoherent motion.

Similar Datasets

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