Identification of Residual Breast Carcinoma Following Neoadjuvant Chemotherapy: Diffusion-weighted Imaging—Comparison with Contrast-enhanced MR Imaging and Pathologic Findings

Woodhams, Reiko; Kakita, Satoko; Hata, Hirofumi; Iwabuchi, Kazuya; Kuranami, Masaru; Gautam, Shiva; Hatabu, Hiroto; Kan, Shinichi; Mountford, Carolyn E.

doi:10.1148/radiol.2542090405

Cited by 146 publications

(128 citation statements)

References 35 publications

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“…This analysis may decrease the number of FN cases. Woodhams et al (16) reported that the accuracy for depicting residual tumors following NAC by DW-MRI is similar to that depicted by contrast material-enhanced MRI. In this study, DW images were referred for the evaluation of tumor response to NAC, however, the final diagnosis of cCR was based on the status of gadolinium enhancement.…”

Section: Discussionmentioning

confidence: 89%

Analysis of complete response by MRI following neoadjuvant chemotherapy predicts pathological tumor responses differently for molecular subtypes of breast cancer

et al. 2012

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Abstract. In the present study, clinical tumor response following neoadjuvant chemotherapy (NAC) was diagnosed by magnetic resonance imaging (MRI) and clinicopathological factors, including molecular subtypes at baseline, were analyzed for correlations with pathological tumor responses. In addition, clinicopathological factors were analyzed for a correlation with the MRI capacity to predict pathological complete response (pCR). Clinical tumor response evaluated by MRI following NAC was determined as a clinical CR (cCR) or a residual tumor. cCR was confirmed if no gadolinium enhancement or an enhancement equal to or less than that of glandular tissue was observed in any phase of the MRI. Pathological tumor responses following NAC were classified into grades 0 (no change) to 3 (no residual invasive cancer) according to criteria of the Japanese Breast Cancer Society. pCR was defined as grade 3 in the present study. Of 264 cases of invasive breast cancer in 260 patients (4 synchronous bilateral breast cancer cases), 59 (22%) were diagnosed by MRI following NAC as cCR and 98 (37%) were pathologically diagnosed as pCR. In terms of predicting pCR by MRI, the sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were 44, 90, 73, 73 and 73%, respectively. Tumor size, hormone receptor status, human epidermal growth factor receptor 2 (HER2) status, molecular subtype and histological type were significantly correlated with pathological tumor responses. pCR rates increased in the following order: luminal/HER2-negative (14%), luminal/HER2-positive (32%), triple-negative (46%) and non-luminal/HER2-positive (73%) tumors. Sensitivity and specificity were the highest (60 and 100%, respectively) in triple-negative tumors. PPV decreased in the following order: triple-negative (100%), non-luminal/HER2-positive (92%), luminal/HER2-positive (46%) and luminal/HER2-negative (33%) tumors. In conclusion, MRI evaluation is useful for predicting pCR following NAC, particularly for triple-negative tumors.

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Section: Discussionmentioning

confidence: 89%

Analysis of complete response by MRI following neoadjuvant chemotherapy predicts pathological tumor responses differently for molecular subtypes of breast cancer

et al. 2012

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“…3 Previous breast DWI studies employed visual assessment of signal intensities and quantitative analysis of the apparent diŠusion coe‹cient (ADC). [3][4][5][6][7][8][9][10][11][12][13] The signal intensity of breast DWI has been reported useful for diagnosing breast carcinoma. 7,9 In DWI, signal intensity and signal contrast between diŠerent tissues depend on b-value.…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5][6][7][8][9][10][11][12][13] The signal intensity of breast DWI has been reported useful for diagnosing breast carcinoma. 7,9 In DWI, signal intensity and signal contrast between diŠerent tissues depend on b-value. Use of a higher b-value improves image contrast 14 and reduces the fractional contribution of perfusion 1 but yields a lower signal-to-noise ratio (SNR).…”

Section: Introductionmentioning

confidence: 99%

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Diffusion-weighted Imaging of the Breast: Comparison of B-values 1000 s/mm2 and 1500 s/mm2

Woodhams

Inoue

Ramadan

et al. 2013

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“…As DWI does not need gadolinium, this method could be advantageous in women with impaired renal function (33).…”

Section: Tumor Persistencementioning

confidence: 99%

The current role of radiologists in a multidisciplinary team treating breast cancer

Cortázar-García

Portero²,

Acebal-Blanco³

et al. 2013

Diagn Interv Radiol

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In the last decade, advances in the diagnosis and treatment of breast cancer have achieved a significant increase in the general and disease-free survival of affected women but have also increased the complexity of therapeutic decisions. The decision-making process requires agreement between the physicians involved in the management of these patients.Radiologists must understand what other physicians expect and inform them about the usefulness of imaging modalities. This review attempts to provide an update on these subjects.

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Identification of Residual Breast Carcinoma Following Neoadjuvant Chemotherapy: Diffusion-weighted Imaging—Comparison with Contrast-enhanced MR Imaging and Pathologic Findings

Cited by 146 publications

References 35 publications

Analysis of complete response by MRI following neoadjuvant chemotherapy predicts pathological tumor responses differently for molecular subtypes of breast cancer

Analysis of complete response by MRI following neoadjuvant chemotherapy predicts pathological tumor responses differently for molecular subtypes of breast cancer

Diffusion-weighted Imaging of the Breast: Comparison of B-values 1000 s/mm2 and 1500 s/mm2

The current role of radiologists in a multidisciplinary team treating breast cancer

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