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Magnetic Resonance Imaging Enhancement Features Before and After Neoadjuvant Chemotherapy in Patients With Breast Cancer: A Predictive Value for Responders

Kang, Doo Kyoung MD; Kim, Tae Hee MD; Han, Tae Sun MD; Kim, Ku Sang MD; Yim, Hyunee MD

Journal of Computer Assisted Tomography: May/June 2013 - Volume 37 - Issue 3 - p 432–439
doi: 10.1097/RCT.0b013e31828386ae
Cardiovascular Imaging

Purpose This study examined the ability of magnetic resonance imaging (MRI) enhancement features to predict the response to neoadjuvant chemotherapy (NAC) in patients with breast cancer.

Methods This retrospective study included 107 patients with breast cancer. All patients underwent a baseline breast MRI before NAC and follow-up MRI a mean of 3.7 months later. Breast MRI scans were evaluated using the Breast Imaging Reporting and Data System MRI lexicon. In addition, whole-breast vascularity (WBV) in the cancer-bearing breast was graded according to increased vessel number in comparison with the contralateral breast. Histopathologic tumor regression was graded semiquantitatively based on the Miller-Payne grading system. The ability of each MRI feature to predict the response was evaluated using a logistic regression analysis. Correlations between changes in MRI features and response were also evaluated using the Spearman rank correlation test.

Results There were 73 responders (68%), including 59 partial and 14 complete responders. No significant difference in baseline MRI features was found between the responders and nonresponders, except for tumor size (P = 0.044). No dynamic enhancement feature on baseline MRI was useful for the early prediction of a response. In addition, an increased WBV did not predict a response, and the WBV change on the follow-up MRI was not correlated with the response. However, the change in the initial enhancement pattern (P = 0.007) and kinetic curve type (P = 0.003) were significantly correlated with response.

Conclusions No baseline MRI feature described using the Breast Imaging Reporting and Data System MRI lexicon was useful for early prediction of the response to NAC.

From the Departments of *Radiology, †Surgery, and ‡Pathology, Ajou University School of Medicine, Suwon, Gyeonggi, South Korea.

Received for publication October 17, 2012; accepted December 17, 2012.

Reprints: Doo Kyoung Kang, MD, Department of Radiology, Ajou University School of Medicine, San 5, Woncheon-dong, Yongtong-gu, Suwon, Gyeonggi-do, 442-749, South Korea (e-mail: kdklsm@ajou.ac.kr).

The authors have no conflict of interest to declare.

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.