Utility of synthetic MRI in predicting pathological complete response of various breast cancer subtypes prior to neoadjuvant chemotherapy

Matsuda, Megumi; Fukuyama, N.; Matsuda, Takayuki; Kikuchi, Shoichi; Shiraishi, Yasuhiro; Takimoto, Y.; Kamei, Yasuhiro; Kurata, Mie; Kitazawa, Riko; Kido, Teruhiko

doi:10.1016/j.crad.2022.06.019

Cited by 8 publications

(11 citation statements)

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“…Moreover, several histogram parameters, such as 10th Percentile, Kurtosis, Energy, Standard Deviation, and so on, were reported to predict tumor molecular subtypes [ 30 ] and lymph node metastasis (LNM) [ 31 ]. The research works [ 18 , 19 ] in breast cancer found changes in T1 during treatment and T2_Standard Deviation were useful to predict pathological response after neoadjuvant therapy. However, treatment response in NPC is difficult to assess accurately due to inaccessibility to biopsy and minor residual and deeply seated abnormalities may be ignored [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…The research [ 17 ] in head and neck region proved the clinical feasibility of generating synthetic T1WI and T2WI images from quantitative relaxometry mapping. Recently, preliminary SyMRI studies have demonstrated a potential role in evaluating prognostic factors in breast [ 18 , 19 ], prostate [ 20 ], bladder [ 21 ], and rectal cancer [ 22 , 23 ]. However, only short-term outcome on tumor was researched and the value of SyMRI on NPC prognostic assessment has not been investigated.…”

Section: Introductionmentioning

confidence: 99%

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Pretreatment synthetic magnetic resonance imaging predicts disease progression in nonmetastatic nasopharyngeal carcinoma after intensity modulation radiation therapy

Yang

Wei

et al. 2023

Insights Imaging

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Background To investigate the potential of synthetic MRI (SyMRI) in the prognostic assessment of patients with nonmetastatic nasopharyngeal carcinoma (NPC), and the predictive value when combined with diffusion-weighted imaging (DWI) as well as clinical factors. Methods Fifty-three NPC patients who underwent SyMRI were prospectively included. 10th Percentile, Mean, Kurtosis, and Skewness of T1, T2, and PD maps and ADC value were obtained from the primary tumor. Cox regression analysis was used for analyzing the association between SyMRI and DWI parameters and progression-free survival (PFS), and then age, sex, staging, and treatment as confounding factors were also included. C-index was obtained by bootstrap. Moreover, significant parameters were used to construct models in predicting 3-year disease progression. ROC curves and leave-one-out cross-validation were used to evaluate the performance and stability. Results Disease progression occurred in 16 (30.2%) patients at a follow-up of 39.6 (3.5, 48.2) months. T1_Kurtosis, T1_Skewness, T2_10th, PD_Mean, and ADC were correlated with PFS, and T1_Kurtosis (HR: 1.093) and ADC (HR: 1.009) were independent predictors of PFS. The C-index of SyMRI and SyMRI + DWI + Clinic models was 0.687 and 0.779. Moreover, the SyMRI + DWI + Clinic model predicted 3-year disease progression better than DWI or Clinic model (p ≤ 0.008). Interestingly, there was no significant difference between the SyMRI model (AUC: 0.748) and SyMRI + DWI + Clinic model (AUC: 0.846, p = 0.092). Conclusion SyMRI combined with histogram analysis could predict disease progression in NPC patients, and SyMRI + DWI + Clinic model further improved the predictive performance.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pretreatment synthetic magnetic resonance imaging predicts disease progression in nonmetastatic nasopharyngeal carcinoma after intensity modulation radiation therapy

Yang

Wei

et al. 2023

Insights Imaging

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“…20 Recently, Matsuda et al evaluated the utility of baseline syMRI parameters for pCR prediction after NAC and found that baseline T2 heterogeneity parameters associated with pCR. 21 This study further evaluated the changes in syMRI parameters throughout NAC. The results indicated that T1 changes after early treatment and PD changes after mid-treatment could differentiate pCR.…”

Section: Discussionmentioning

confidence: 99%

“…20 A recent study has reported that syMRI before NAC can help predict breast cancer pCR after NAC. 21 With these promising results, this study was aimed to investigate the time course changes of syMRI parameters during NAC and determine the optimal parameter for treatment response evaluation in breast cancer.…”

mentioning

confidence: 99%

“…Clinical studies have demonstrated the value of syMRI in differentiating between benign and malignant breast lesions 18 and evaluating pathological factors 19 and molecular subtype 20 . A recent study has reported that syMRI before NAC can help predict breast cancer pCR after NAC 21 . With these promising results, this study was aimed to investigate the time course changes of syMRI parameters during NAC and determine the optimal parameter for treatment response evaluation in breast cancer.…”

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confidence: 99%

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Time Course Changes of Synthetic Relaxation Time During Neoadjuvant Chemotherapy in Breast Cancer: The Optimal Parameter for Treatment Response Evaluation

Zhao

Gao

et al. 2023

Magnetic Resonance Imaging

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BackgroundSynthetic MRI (syMRI) has enabled quantification of multiple relaxation parameters (T1/T2 relaxation time [T1/T2], proton density [PD]), and their longitudinal change during neoadjuvant chemotherapy (NAC) promises to be valuable parameters for treatment response evaluation in breast cancer.PurposeTo investigate the time course changes of syMRI parameters during NAC and evaluate their value as predictors for pathological complete response (pCR) in breast cancer.Study TypeRetrospective, longitudinal.PopulationA total of 129 women (median age, 50 years; range, 28–69 years) with locally advanced breast cancer who underwent NAC; all performed multiple conventional breast MRI examinations with added syMRI during NAC.Field Strength/SequenceA 3.0 T, T1‐weighted dynamic contrast enhanced and syMRI acquired by a multiple‐dynamic, multiple‐echo sequence.AssessmentBreast MRI was set at four time‐points: baseline, after one cycle, after three or four cycles of NAC and preoperation. SyMRI parameters and tumor diameters were measured and their changes from baseline were calculated. All parameters were compared between pCR and non‐pCR. Interaction between syMRI parameters and clinicopathological features was analyzed.Statistical TestsMann–Whitney U tests, random effects model of repeated measurement, receiver operating characteristic (ROC) analysis, interaction analysis.ResultsMedian synthetic T1/T2/PD and tumor diameter generally decreased throughout NAC. Absolute T1 at early‐NAC, T1, and PD at mid‐NAC were significantly lower in the pCR group. After early‐NAC, the T1 change was significantly higher in the pCR (median ± IQR, 18.17 ± 11.33) than the non‐pCR group (median ± IQR, 10.90 ± 10.03), with the highest area under the ROC curves (AUC) of 0.769 (95% CI, 0.684–0.838). Interaction analysis showed that histological grade III patients had higher odds ratio (OR) (OR = 1.206) compared to grade II patients (OR = 1.067).Data ConclusionSynthetic T1 changes after one cycle of NAC maybe useful for early evaluating NAC response in breast cancer during whole treatment cycles. However, its discriminative ability is significantly affected by histological grade.Evidence Level4Technical EfficacyStage 2.

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Pretreatment synthetic MRI features for triple-negative breast cancer

Zhang,

Zhao,

Nie

et al. 2024

Clinical Radiology

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Utility of synthetic MRI in predicting pathological complete response of various breast cancer subtypes prior to neoadjuvant chemotherapy

Cited by 8 publications

References 30 publications

Pretreatment synthetic magnetic resonance imaging predicts disease progression in nonmetastatic nasopharyngeal carcinoma after intensity modulation radiation therapy

Pretreatment synthetic magnetic resonance imaging predicts disease progression in nonmetastatic nasopharyngeal carcinoma after intensity modulation radiation therapy

Time Course Changes of Synthetic Relaxation Time During Neoadjuvant Chemotherapy in Breast Cancer: The Optimal Parameter for Treatment Response Evaluation

Pretreatment synthetic MRI features for triple-negative breast cancer

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