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Computer-aided Evaluation of DCE MR Images Helps Predict Breast Cancer Survival

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breast cancer survival

Based on a new study published in the September issue of the journal Radiology, size and perfusion changes of breast cancers prior to and following neoadjuvant chemotherapy (NAC) alongside computer-aided assessment of dynamic contrast agent-enhanced (DCE) MR images provide realistic imaging boundaries connected to survival.

‘The study was the first to use commercialized evaluation software in the NAC setting of breast cancer patients,’ stated Ann Yi, MD, of Seoul National University College of Medicine, Seoul, South Korea, and colleagues. 

To confirm whether computer-assessed DCE MR boundaries are linked with recurrence-free and overall survival in breast cancer patients who received NAC, Yi and colleagues retrospectively reviewed data from 187 consecutive women who had undergone NAC between January 2007 and December 2009.

Every patient had DCE MR imaging prior to and following NAC and surgery. A computer-aided assessment program measured tumor size, volume, and kinetic parameters, such as failure component.

According to the authors, there were 50 instances after an average follow-up of 47.4 months, which included 12 deaths and 38 recurrences; 29 distant, six local, and three both distant and local.

Multidimensional analysis showed that a smaller decline in tumor size and a smaller reduction in failure component following NAC were separate major variables for worse recurrence-free survival and overall survival.

Yi and peers used a 91.3 percent failure component decline as a cutoff point for worse overall survival. Patients with tumors that had less than 91.3 percent decline in the failure component had a three-year overall survival rate of 84.8 percent as opposed to 95.7 percent for those with a greater decline in the failure component.

“Thus, when a breast cancer patient showed a smaller reduction (<91.3%) in the washout component within a tumor at DCE MR imaging after NAC, targeted therapy for angiogenesis may be considered,” wrote the authors.

Yi and peers also mentioned that the differences in survival with the DCE MR imaging parameters used in the study endured after adjusting for multiple clinical-pathologic factors.

These included menopausal status, histologic grade, clinical and pathologic response and pathologic tumor stage. The study also contributes to prior research that has revealed volumetric measurement was greater to diameter measurement or clinical assessment when predicting response to NAC.

“On the basis of our observation, DCE MR imaging with computer-aided evaluation has the potential to serve as an additional tool for the risk stratification of patients with breast cancers who receive NAC,” said Yi.

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