Skip to main content

Prognostic value of pre-treatment DCE-MRI parameters in predicting disease free and overall survival for breast cancer patients undergoing neoadjuvant chemotherapy

Pickles, Martin D.; Manton, David J.; Lowry, Martin; Turnbull, Lindsay W.

Authors

Martin D. Pickles

David J. Manton

Martin Lowry

Lindsay W. Turnbull



Abstract

The purpose of this study was to investigate whether dynamic contrast enhanced MRI (DCE-MRI) data, both pharmacokinetic and empirical, can predict, prior to neoadjuvant chemotherapy, which patients are likely to have a shorter disease free survival (DFS) and overall survival (OS) interval following surgery. Traditional prognostic parameters were also included in the survival analysis. Consequently, a comparison of the prognostic value could be made between all the parameters studied. MR examinations were conducted on a 1.5 T system in 68 patients prior to the initiation of neoadjuvant chemotherapy. DCE-MRI consisted of a fast spoiled gradient echo sequence acquired over 35 phases with a mean temporal resolution of 11.3 s. Both pharmacokinetic and empirical parameters were derived from the DCE-MRI data. Kaplan-Meier survival plots were generated for each parameter and group comparisons were made utilising logrank tests. The results from the 54 patients entered into the univariate survival analysis demonstrated that traditional prognostic parameters (tumour grade, hormonal status and size), empirical parameters (maximum enhancement index, enhancement index at 30 s, area under the curve and initial slope) and adjuvant therapies demonstrated significant differences in survival intervals. Further multivariate Cox regression survival analysis revealed that empirical enhancement parameters contributed the greatest prediction of both DFS and OS in the resulting models. In conclusion, this study has demonstrated that in patients who exhibit high levels of perfusion and vessel permeability pre-treatment, evidenced by elevated empirical DCE-MRI parameters, a significantly lower disease free survival and overall survival can be expected. © 2008 Elsevier Ireland Ltd. All rights reserved.

Journal Article Type Article
Publication Date Sep 1, 2009
Journal European Journal Of Radiology
Print ISSN 0720-048X
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 71
Issue 3
Pages 498-505
APA6 Citation Pickles, M. D., Manton, D. J., Lowry, M., & Turnbull, L. W. (2009). Prognostic value of pre-treatment DCE-MRI parameters in predicting disease free and overall survival for breast cancer patients undergoing neoadjuvant chemotherapy. European Journal of Radiology, 71(3), (498-505). doi:10.1016/j.ejrad.2008.05.007. ISSN 0720-048X
DOI https://doi.org/10.1016/j.ejrad.2008.05.007
Keywords Radiology Nuclear Medicine and imaging; General Medicine
Publisher URL https://www.sciencedirect.com/science/article/pii/S0720048X08002490?via%3Dihub
;