Open Access Research article

Accuracy of perfusion MRI with high spatial but low temporal resolution to assess invasive breast cancer response to neoadjuvant chemotherapy: a retrospective study

Cédric de Bazelaire1*, Raphael Calmon1, Isabelle Thomassin2, Clément Brunon3, Anne-Sophie Hamy4, Laure Fournier3, Daniel Balvay3, Marc Espié4, Nathalie Siauve3, Olivier Clément3, Eric de Kerviler1 and Charles-André Cuénod3

Author Affiliations

1 Radiologie, Hôpital Saint-Louis - Inserm U728 - Université Paris VII, 1 Avenue Claude Vellefaux, Paris, 75010, France

2 Radiologie, Hôpital Tenon - Inserm U970 - Université Paris VI, 4 rue de la chine, Paris, 75020, France

3 Radiologie, Hôpital Européen George Pompidou - Inserm U970 - Université Paris V, 56 Rue Leblanc, Paris, 75015, France

4 Centre des maladies du sein, Hôpital Saint-Louis - Université Paris 7, 1 Avenue Claude Vellefaux, Paris, 75015, France

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BMC Cancer 2011, 11:361  doi:10.1186/1471-2407-11-361

Published: 19 August 2011

Abstract

Background

To illustrate that Breast-MRI performed in high spatial resolution and low temporal resolution (1 minute) allows the measurement of kinetic parameters that can assess the final pathologic response to neoadjuvant chemotherapy in breast cancer.

Methods

Breast-MRI was performed in 24 women before and after treatment. Eight series of 1.11 minute-duration were acquired with a sub-millimeter spatial resolution. Transfer constant (Ktrans) and leakage space (Ve) were calculated using measured and theoretical Arterial Input Function (AIF). Changes in kinetic parameters after treatment obtained with both AIFs were compared with final pathologic response graded in non-responder (< 50% therapeutic effect), partial-responder (> 50% therapeutic effect) and complete responder. Accuracies to identify non-responders were compared with receiver operating characteristic curves.

Results

With measured-AIF, changes in kinetic parameters measured after treatment were in agreement with the final pathological response. Changes in Ve and Ktrans were significantly different between non-(N = 11), partial-(N = 7), and complete (N = 6) responders, (P = 0.0092 and P = 0.0398 respectively). A decrease in Ve of more than -72% and more than -84% for Ktrans resulted in 73% sensitivity for identifying non-responders (specificity 92% and 77% respectively). A decrease in Ve of more than -87% helped to identify complete responders (Sensitivity 89%, Specificity 83%). With theoretical-AIF, changes in kinetic parameters had lower accuracy.

Conclusion

There is a good agreement between pathological findings and changes in kinetic parameters obtained with breast-MRI in high spatial and low temporal resolution when measured-AIF is used. Further studies are necessary to confirm whether MRI contrast kinetic parameters can be used earlier as a response predictor to neoadjuvant chemotherapy.