Ann Yi MD, Presenter: Nothing to Disclose

Nariya Cho MD, Abstract Co-Author: Nothing to Disclose

Seung JA Kim, Abstract Co-Author: Nothing to Disclose

Woo Kyung Moon, Abstract Co-Author: Nothing to Disclose

To retrospectively evaluate whether DCE-MRI variables assessed by a computer-aided evaluation program (CAE) are associated with disease-free and overall survivals in breast cancer patients receiving neoadjuvant chemotherapy (NAC).  

Between January 2007 and December 2009, 187 consecutive women (mean age, 46.6 years; range, 24 - 78 years) with invasive breast cancers (mean size, 5.0 cm; range, 2.0 - 14.8 cm) who had undergone NAC, DCE-MRI before and after chemotherapy, and surgery were identified. Tumor size, volume, and kinetic parameters (persistent, plateau, or washout components) measured by CAE before and after chemotherapy as well as their % changes were calculated. Receiver operating characteristic curve was used to determine the best cut-off value of each variable for the prediction of events. Kaplan-Meier method and Cox proportional hazards model were used to determine associations between DCE-MRI variables and overall survival (OS) and disease-free survival (DFS) outcomes after controlling for clinicopathologic variables including initial tumor size, histologic grade, estrogen receptor status, and responsiveness according to RECIST.  

There were 59 events (12 deaths, 38 metastases, and 9 local recurrences) at a mean follow-up of 47.4 months. On multivariate analysis, a higher residual washout component (OS HR, 1.26; 95% CI, 1.03 to 1.52) (DFS HR, 1.15; 95% CI, 1.06 to 1.55) and greater tumor volume (OS HR, 2.12; 95% CI, 1.08 to 5.69) (DFS HR, 5.75; 95% CI, 1.14 to 8.64) after NAC were independently significant factors for both worse OS and DFS. Three-year OS for the higher residual washout group was 88.5% vs. 98.8% in the lower residual washout group (P = .003) and the greater tumor volume group was 84.8% vs. 95.7% in the smaller tumor volume group (P = .008). Three-year DFS for the higher residual washout group was 77.1% vs. 85.5% in the lower residual washout group (P = .026) and the greater tumor volume group was 61.2% vs. 85.9% in the smaller tumor volume group (P = .002).  

A higher residual washout component and greater tumor volume after NAC were independent predictors for worse OS and DFS outcomes in breast cancer patients.  

In addition to the volume change, a higher residual washout component after NAC on DCE-MRI predicts both worse overall and disease-free survival in breast cancer patients.  

Yi, A, Cho, N, Kim, S, Moon, W, DCE-MRI with Computer-Aided Evaluation (CAE) in the Prediction of Survival Outcomes of Breast Cancer Patients Receiving Neoadjuvant Chemotherapy.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12031305.html