Prediction of neoadjuvant chemotherapy efficacy in breast cancer: integrating multimodal imaging and clinical features.

IF 2.9 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

BMC Medical Imaging Pub Date : 2025-04-14 DOI:10.1186/s12880-025-01631-2

Xianglong Chen, Yong Luo, Zhiming Xie, Yun Wen, Fangsheng Mou, Wenbing Zeng

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引用次数: 0

Abstract

Objectives: To assess the predictive value of combining DCE-MRI, DKI, IVIM parameters, and clinical characteristics for neoadjuvant chemotherapy (NAC) efficacy in invasive ductal carcinoma.

Methods: We conducted a retrospective study of 77 patients with invasive ductal carcinoma, analyzing MRI data collected before NAC. Parameters extracted included DCE-MRI (Ktrans, Kep, Ve, wash-in, wash-out, TTP, iAUC), DKI (MK, MD), and IVIM (D, D*, f). Differences between NAC responders and non-responders were assessed using t-tests or Mann-Whitney U tests. ROC curves and Spearman correlation analyses evaluated predictive accuracy.

Results: NAC responders had higher DCE-MRI-Kep, DKI-MD, IVIM-D, and IVIM-f values. Non-responders had higher DCE-MRI-Ve, DKI-MK, IVIM-D (kurtosis, skewness, entropy), and IVIM-f (entropy). The mean DKI-MK had the highest AUC (0.724), and IVIM-D interquartile range showed the highest sensitivity (94.12%). Combined parameters had the highest AUC (0.969), sensitivity (94.12%), and specificity (90.70%). HER2 status (OR, 0.187; 95% CI: 0.038, 0.914; P = 0.038) and tumor margin (OR, 20.643; 95% CI: 2.892, 147.365; P = 0.003) were identified as independent factors influencing the lack of significant efficacy of neoadjuvant chemotherapy (NAC) in breast cancer.

Conclusions: Combining DCE-MRI, DKI, and IVIM parameters effectively predicts NAC efficacy, providing valuable preoperative assessment insights.

Clinical trial number: Not applicable.

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预测乳腺癌新辅助化疗的疗效：综合多模式影像和临床特征。

目的：评价综合DCE-MRI、DKI、IVIM参数及临床特征对浸润性导管癌新辅助化疗（NAC）疗效的预测价值。方法：我们对77例浸润性导管癌进行回顾性研究，分析NAC前收集的MRI资料。提取的参数包括DCE-MRI (Ktrans, Kep, Ve, wash-in, wash-out， TTP, iAUC), DKI (MK， MD), IVIM （D, D*, f）。NAC反应者和无反应者之间的差异采用t检验或Mann-Whitney U检验进行评估。ROC曲线和Spearman相关分析评估预测准确性。结果：NAC应答者的dce - mri - keep、DKI-MD、IVIM-D和IVIM-f值较高。无应答者的DCE-MRI-Ve、DKI-MK、IVIM-D（峰度、偏度、熵）和IVIM-f（熵）较高。平均DKI-MK具有最高的AUC (0.724)， IVIM-D四分位数范围具有最高的灵敏度（94.12%）。综合参数的AUC（0.969）、灵敏度（94.12%）和特异度（90.70%）最高。HER2状态(OR, 0.187；95% ci: 0.038, 0.914；P = 0.038)和肿瘤边缘(OR, 20.643；95% ci: 2.892, 147.365；P = 0.003)是影响乳腺癌新辅助化疗（NAC）缺乏显著疗效的独立因素。结论：综合DCE-MRI、DKI、IVIM参数可有效预测NAC疗效，为术前评估提供有价值的见解。临床试验号：不适用。

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来源期刊

BMC Medical Imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

4.60

自引率

3.70%

发文量

198

审稿时长

27 weeks

期刊介绍： BMC Medical Imaging is an open access journal publishing original peer-reviewed research articles in the development, evaluation, and use of imaging techniques and image processing tools to diagnose and manage disease.