Study of 3D 1 H-MRS combined DWI in evaluating the response to neoadjuvant chemotherapy of breast cancer / 实用放射学杂志

ABSTRACT

Objective To determine whether tChoI and ADC and their changes could be applied to predict pathologic response be-fore,during and after NAC of locally advanced breast.To assess the diagnostic performance of each parameter.Methods The tChoI and ADC and their changes in 22 women who underwent MRI before,during and after the NAC were analyzed prospectively.All pa-tients were divided into major histological response group and non-major histological response group by methods of Miller and Payne system according to the final pathologic response.Pre-and post-treatment measurements and changes in tChoI and ADC values in MHR versus NMHR were analyzed using Mann-Whitney U test.ROC curve analysis was performed to assess the diagnostic per-formance of each parameter and also to identify which parameter could be used to predict the pathologic response to NAC and find the optimal cut off value for MHR prediction.Results After NAC,14 patients showed MHR and 8 showed NMHR.After NAC,all the parameters and their changes were significantly different between the MHR and NMHR groups,the change rate of all parameters af-ter NAC can actively diagnosis the MHR according ROC(AUC>0.5).Using 0.913 ×10 -3 mm2/s of ADCmin after NAC as the cut off value,prediction of MHR with sensitivity and specificity was 85.7% and 100%,respectively.Using 81.25% of the change rate of tCho I after NAC as the cut off value,prediction of MHR with sensitivity and specificity was 71.4% and 100%,respectively(AUC=0.881,P =0.008).The △ADCmin 2% and △tChoI2% are better than △ADCmean 2%.Conclusion Application of 3D 1 H-MRS and DWI can predict pathologic response and may provide more detailed and accurate evidence for subsequent treatment.