Dynamic contrast-enhanced magnetic resonance imaging and diffusion-weighted magnetic resonance imaging for predicting the response of locally advanced breast cancer to neoadjuvant therapy: a meta-analysis

John Virostko; Allison Hainline; Hakmook Kang; Lori R. Arlinghaus; Richard G. Abramson M.D.; Stephanie L. Barnes; Jeffrey D. Blume; Sarah Avery M.D.; Debra Patt M.D.; Boone Goodgame; Thomas E. Yankeelov; Anna G. Sorace

doi:10.1117/1.JMI.5.1.011011

24 November 2017 Dynamic contrast-enhanced magnetic resonance imaging and diffusion-weighted magnetic resonance imaging for predicting the response of locally advanced breast cancer to neoadjuvant therapy: a meta-analysis

John Virostko, Allison Hainline, Hakmook Kang, Lori R. Arlinghaus, Richard G. Abramson M.D., Stephanie L. Barnes, Jeffrey D. Blume, Sarah Avery M.D., Debra Patt M.D., Boone Goodgame, Thomas E. Yankeelov, Anna G. Sorace

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Journal of Medical Imaging, Vol. 5, Issue 1, 011011 (November 2017). https://doi.org/10.1117/1.JMI.5.1.011011

Abstract

This meta-analysis assesses the prognostic value of quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted MRI (DW-MRI) performed during neoadjuvant therapy (NAT) of locally advanced breast cancer. A systematic literature search was conducted to identify studies of quantitative DCE-MRI and DW-MRI performed during breast cancer NAT that report the sensitivity and specificity for predicting pathological complete response (pCR). Details of the study population and imaging parameters were extracted from each study for subsequent meta-analysis. Metaregression analysis, subgroup analysis, study heterogeneity, and publication bias were assessed. Across 10 studies that met the stringent inclusion criteria for this meta-analysis (out of 325 initially identified studies), we find that MRI had a pooled sensitivity of 0.91 [95% confidence interval (CI), 0.80 to 0.96] and specificity of 0.81(95% CI, 0.68 to 0.89) when adjusted for covariates. Quantitative DCE-MRI exhibits greater specificity for predicting pCR than semiquantitative DCE-MRI ( p<0.001). Quantitative DCE-MRI and DW-MRI are able to predict, early in the course of NAT, the eventual response of breast tumors, with a high level of specificity and sensitivity. However, there is a high degree of heterogeneity in published studies highlighting the lack of standardization in the field.

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John Virostko, Allison Hainline, Hakmook Kang, Lori R. Arlinghaus, Richard G. Abramson M.D., Stephanie L. Barnes, Jeffrey D. Blume, Sarah Avery M.D., Debra Patt M.D., Boone Goodgame, Thomas E. Yankeelov, and Anna G. Sorace "Dynamic contrast-enhanced magnetic resonance imaging and diffusion-weighted magnetic resonance imaging for predicting the response of locally advanced breast cancer to neoadjuvant therapy: a meta-analysis," Journal of Medical Imaging 5(1), 011011 (24 November 2017). https://doi.org/10.1117/1.JMI.5.1.011011

Received: 7 July 2017; Accepted: 6 November 2017; Published: 24 November 2017

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