Dataset Information

Quantitative Apparent Diffusion Coefficients From Peritumoral Regions as Early Predictors of Response to Neoadjuvant Systemic Therapy in Triple-Negative Breast Cancer.

ABSTRACT:

Background

Pathologic complete response (pCR) to neoadjuvant systemic therapy (NAST) in triple-negative breast cancer (TNBC) is a strong predictor of patient survival. Edema in the peritumoral region (PTR) has been reported to be a negative prognostic factor in TNBC.

Purpose

To determine whether quantitative apparent diffusion coefficient (ADC) features from PTRs on reduced field-of-view (rFOV) diffusion-weighted imaging (DWI) predict the response to NAST in TNBC.

Study type

Prospective.

Population/subjects

A total of 108 patients with biopsy-proven TNBC who underwent NAST and definitive surgery during 2015-2020.

Field strength/sequence

A 3.0 T/rFOV single-shot diffusion-weighted echo-planar imaging sequence (DWI).

Assessment

Three scans were acquired longitudinally (pretreatment, after two cycles of NAST, and after four cycles of NAST). For each scan, 11 ADC histogram features (minimum, maximum, mean, median, standard deviation, kurtosis, skewness and 10th, 25th, 75th, and 90th percentiles) were extracted from tumors and from PTRs of 5 mm, 10 mm, 15 mm, and 20 mm in thickness with inclusion and exclusion of fat-dominant pixels.

Statistical tests

ADC features were tested for prediction of pCR, both individually using Mann-Whitney U test and area under the receiver operating characteristic curve (AUC), and in combination in multivariable models with k-fold cross-validation. A P value < 0.05 was considered statistically significant.

Results

Fifty-one patients (47%) had pCR. Maximum ADC from PTR, measured after two and four cycles of NAST, was significantly higher in pCR patients (2.8 ± 0.69 vs 3.5 ± 0.94 mm² /sec). The top-performing feature for prediction of pCR was the maximum ADC from the 5-mm fat-inclusive PTR after cycle 4 of NAST (AUC: 0.74; 95% confidence interval: 0.64, 0.84). Multivariable models of ADC features performed similarly for fat-inclusive and fat-exclusive PTRs, with AUCs ranging from 0.68 to 0.72 for the cycle 2 and cycle 4 scans.

Data conclusion

Quantitative ADC features from PTRs may serve as early predictors of the response to NAST in TNBC.

Evidence level

1 TECHNICAL EFFICACY: Stage 4.

SUBMITTER: Musall BC

PROVIDER: S-EPMC9626398 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Publications

Quantitative Apparent Diffusion Coefficients From Peritumoral Regions as Early Predictors of Response to Neoadjuvant Systemic Therapy in Triple-Negative Breast Cancer.

Musall Benjamin C BC Adrada Beatriz E BE Candelaria Rosalind P RP Mohamed Rania M M RMM Abdelhafez Abeer H AH Son Jong Bum JB Sun Jia J Santiago Lumarie L Whitman Gary J GJ Moseley Tanya W TW Scoggins Marion E ME Mahmoud Hagar S HS White Jason B JB Hwang Ken-Pin KP Elshafeey Nabil A NA Boge Medine M Zhang Shu S Litton Jennifer K JK Valero Vicente V Tripathy Debu D Thompson Alastair M AM Yam Clinton C Wei Peng P Moulder Stacy L SL Pagel Mark D MD Yang Wei T WT Ma Jingfei J Rauch Gaiane M GM

Journal of magnetic resonance imaging : JMRI 20220502 6

<h4>Background</h4>Pathologic complete response (pCR) to neoadjuvant systemic therapy (NAST) in triple-negative breast cancer (TNBC) is a strong predictor of patient survival. Edema in the peritumoral region (PTR) has been reported to be a negative prognostic factor in TNBC.<h4>Purpose</h4>To determine whether quantitative apparent diffusion coefficient (ADC) features from PTRs on reduced field-of-view (rFOV) diffusion-weighted imaging (DWI) predict the response to NAST in TNBC.<h4>Study type</h ...[more]

PMID: 35499264

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Project description:BackgroundThe invasion depth of endometrial cancer is one of the most important prognosis factors. The aim of the current study was to investigate the diagnostic value of the apparent diffusion coefficient (ADC) of the peritumoral zone for assessing the infiltration depth of endometrial cancer.MethodsAn institutional review board approved this prospective study, and all study participants provided informed consent. A total of 58 patients (mean age 54 ± 8.3 years, range 34-69 years) with endometrial cancer were prospectively enrolled. Two radiologists assessed all preoperative magnetic resonance images with T1, T2, and diffusion-weighted imaging, and determined the location of the deepest invasion of the tumor. The peritumoral zone was defined as a 5-mm-thick zone surrounding and adjacent to the cancerous endometrium. The mean ADC (ADCm) values of the tumor and the peritumoral zone were measured. Sensitivity, specificity, positive and negative predictive values, and the area under the receiver operating characteristic curve (Az) were calculated for visual inspection, and an ADC cutoff value for the peri-endometrial zone was determined for predicting the myometrial invasion depth.ResultsThe ADCm values of tumors and peritumoral zones were 0.83 × 10- 3 mm2/sec and 1.06 × 10- 3 mm2/sec, respectively. There was no significant difference between the ADCm values of the tumors in the superficial and deep myometrial invasion groups (P > 0.05). However, the ADCm value at the peritumoral zone in the deep myometrial invasion group (1.23 × 10- 3 mm2/sec) significantly differed from that in the superficial myometrial invasion group (0.99 × 10- 3 mm2/sec) (p = 0.005). In assessments of deep myometrial invasion, the sensitivity, specificity, negative predictive value, and positive predictive value were 0.58, 0.93, 0.84, and 0.77, respectively, for the ADCm cutoff value of the peritumoral zone, and 0.71, 0.80, 0.87, and 0.60. respectively, for visual inspection. The accuracy of myometrial invasion depth assessment using the ADCm cutoff value and visual inspection were 83 and 78%, respectively. The Az for both was 0.76.ConclusionADCm at the peritumoral zone can predict deep myometrial invasion of endometrial cancer. This value can therefore enhance confidence in preoperative endometrial cancer evaluation, and when tailoring surgical approaches.

Project description:ObjectiveTo evaluate the predictive value of the apparent diffusion coefficient (ADC) for pathologic complete response (pCR) to neoadjuvant chemoradiotherapy (NCRT) in locally advanced rectal cancer.MethodsA total of 265 patients with rectal adenocarcinoma, whole Diffusion-Weighted MRI (DWI-MRI) images, clinically stage II to III (cT3-4 and/or cN+) and treated with NCRT followed by TME were screened. Fifty patients with pCR and another 50 patients without pCR with similar clinical charcacters and treatment regimens were selected for statistical analysis. All the patients' pre-CRT and post-CRT average ADC values were calculated from the coefficient maps created by DWI-MRI and recorded independently. The difference in the ADC values between the pCR and non-pCR was analyzed by the Mann-Whitney U test. The cut-off ADC value of the receiver operating characteristic (ROC) curve with pCR was then established.ResultsThe mean pre- and post-ADC values in all patients, and in pCR patients and non-pCR patients were 0.879±0.06 and 1.383±0.11, 0.859±0.04 and 1.440±0.10, 0.899±0.07 and 1.325±0.09 (×10(-3) mm(2)/s), respectively. The difference between the pre- and post-ADC values in all patients, pCR patients, and non-pCR patients were considered to be statistically significant. The pre-ADC value was significantly lower in the pCR patients than in the non-pCR patients (p = 0.003), whereas the post-ADC values were significantly higher in the pCR patients than in the non-pCR patients. The percentage increase of the ADC value (?ADC%) in the pCR and non-pCR patients were 68% and 48% respectively (p<0.001). The ROC curves of the cut-off value of the pre-CRT patient ADC value was 0.866×10(-3) mm(2)/s. The AUC, sensitivity, specificity, PPV, NPV, and accuracy of diagnosing pCR were 0.670 (95% CI 0.563-0.777), 0.600, 0.640, 60%, 60%, and 60%, respectively. The cut-off value of ?ADC% was 58%. The corresponding AUC, sensitivity, specificity, PPV, NPV, and accuracy of diagnosing pCR were 0.856 (95% CI 0.783-0.930), 0.800, 0.760, 76.9%, 79.2%, and 78%, respectively.ConclusionsDWI-MRI technology can be efficient for predicting pCR for LARC after NCRT. Although the mean pre-CRT ADC value and the ?ADC% are moderate predictors for pCR, the latter would be more accurate.

Dataset Information

Quantitative Apparent Diffusion Coefficients From Peritumoral Regions as Early Predictors of Response to Neoadjuvant Systemic Therapy in Triple-Negative Breast Cancer.

Background

Purpose

Study type

Population/subjects

Field strength/sequence

Assessment

Statistical tests

Results

Data conclusion

Evidence level

Publications

Quantitative Apparent Diffusion Coefficients From Peritumoral Regions as Early Predictors of Response to Neoadjuvant Systemic Therapy in Triple-Negative Breast Cancer.

Similar Datasets

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