Feasibility Study of DCE-MRI in Predicting Pathological Complete Remission of Breast Cancer after NAC Treatment
Objective To analyze the feasibility of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in predicting pathological complete remission(pCR)after neoadjuvant chemotherapy(NAC)for breast cancer.Methods A total of 120 patients with breast cancer treated with NAC from August 2018 to December 2022 in our hospital were collected.All patients were treated with NAC before radical surgery.After surgery,the pCR status of patients after treatment was evaluated by Miller&Payne's modified pathological reaction standard.Compare the quantitative parameter values of DCE-MRI(Ktrans,Ve,Kep)before and after chemotherapy,as well as between the pCR group and the unrelieved group;To explore the factors related to pathological complete remission after NAC treatment for breast cancerand analyze the efficacy of DCE-MRI in predicting pCR after NAC treatment for breast cancer by drawing Receiver operating characteristicResuts The Miller&Payne grading of 120 patients showed that there were 86 cases of grade Ⅰ to Ⅲ(unrelieved group)and 34 cases of grade Ⅳ to Ⅴ(pCR group);The Ktrans,Ve,and Kep values of patients after NAC treatment were significantly lower than those before NAC treatment(P＜0.05);The Ktrans,Ve,and Kep values of patients in the pCR group were significantly lower than those in the unrelieved group(P＜0.05).There was no statistically significant difference between the pCR group and the unrelieved group in terms of age,tumor diameter,fertility status,pathological type,NAC treatment plan,and molecular typing(P＞0.05),The proportion of patients with TNM stage Ⅱ in the pCR group was higher than that in the unrelieved group(35.29％vs 12.79％)(P＜0.05);Logistic regression analysis was conducted using pCR and non remission as dependent variables and TNM stage,Ktrans,Ve,and Kep as independent variables.The results showed that TNM stage[95％CI:(1.076-2.611)],Ktrans[95％CI:(1.120-1.678)],Ve[95％CI:(1.253-2.479)],and Kep 95％CI(1.295-1.963)]were independent risk factors affecting pCR(P＜0.01);The ROC results showed that Ktrans+Ve+Kep predicted an AUC value of 0.879 for pCR,which was higher than Krans,Ve,and Kep tested separately(P＜0.05).Conclusion There were significant changes in the quantitative parameters Ktrans,Ve,and Kep of DCE-MRI before and after NAC treatment,which showed lower levels in pCR patients after NAC treatment;Obtaining DCE-MRI imaging data to predict pCR after NAC treatment is highly feasible and beneficial for guiding clinical improvement of individualized treatment plans in the future.
Dynamic Enhanced Magnetic ResonanceBreast CancerNeoadjuvant ChemotherapyPathology in Complete Remission
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