Abstract
Figures and Tables
Fig. 1
Examples of the response evaluation using MR-CAD, DWI and PET/CT. (A) DCE-MRI analysis using MR-CAD provided information regarding the size, volume and kinetics of a tumor using automatic segmentation. (B) For DWI analysis, the ADC values were obtained by manually drawing an ROI within a hypointense tumor on the ADC map. (C) For PET/CT analysis, ROIs were manually placed over tumors in attenuation-corrected images, and the peak standardized uptake values (pSUV) within the ROIs were recorded.
![jkms-30-808-g001](/upload/SynapseData/ArticleImage/0063jkms/jkms-30-808-g001.jpg)
Fig. 2
Box-plots comparing the percent changes of the quantitative parameters in DCE-MRI (LD, TV, PE), DWI (ADC) and PET/CT (SUV max). The mean percent change of the imaging parameters measured by DCE-MRI and PET/CT was decreased more in responders than in non-responders. By contrast, the mean percent change of the ADC value was increased more in the responder group.
![jkms-30-808-g002](/upload/SynapseData/ArticleImage/0063jkms/jkms-30-808-g002.jpg)
Fig. 3
ROC curve analyses of DCE-MRI, DWI and PET/CT for the prediction of pathologic responses. The AUC values for the DCE-MRI, DWI and PET/CT were 0.77 (95% CI = 0.28 to 0.89), 0.59 (95% CI = 0.28 to 0.89) and 0.76 (95% CI = 0.34 to 1.00), respectively. The DCE-MRI analysis using all three CAD parameters resulted in the highest diagnostic performance compared with DWI or PET/CT.
![jkms-30-808-g003](/upload/SynapseData/ArticleImage/0063jkms/jkms-30-808-g003.jpg)
Table 1
The clinicopathological characteristics of 20 breast cancer patients in this study
![jkms-30-808-i001](/upload/SynapseData/ArticleImage/0063jkms/jkms-30-808-i001.jpg)
Table 2
The response assessment criteria of DCE-MRI and PET/CT used in our study
![jkms-30-808-i002](/upload/SynapseData/ArticleImage/0063jkms/jkms-30-808-i002.jpg)
RECIST, Response Evaluation Criteria in Solid Tumors; CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease; PERCIST, PET Response Evaluation Criteria in Solid Tumor; SUV, standardized uptake value; 18F-FDG, fluorine 18 fluorodeoxyglucose; ROI, region of interest; CMR, complete metabolic response; PMR, partial metabolic response; SMD, stable metabolic disease; PMD, progressive metabolic disease.
Table 3
Agreement between RECIST 1.1 and PERCIST criteria with RCB index
![jkms-30-808-i003](/upload/SynapseData/ArticleImage/0063jkms/jkms-30-808-i003.jpg)
Criteria | Kappa value | Percent agreement | P value |
---|---|---|---|
RECIST 1.1 | 0.08 | 0.35 | 0.0003 |
PERCIST | 0.14 | 0.44 | 0.0027 |
Table 4
Comparison between percent changes of the parameters in DCE-MRI using CAD analysis, DWI and PET/CT and pathological response status
![jkms-30-808-i004](/upload/SynapseData/ArticleImage/0063jkms/jkms-30-808-i004.jpg)
Table 5
Diagnostic performance of DCE-MRI, DWI and PET/CT the prediction of pathologic response status
![jkms-30-808-i005](/upload/SynapseData/ArticleImage/0063jkms/jkms-30-808-i005.jpg)
Table 6
Diagnostic performance of the combined use of the different parameters for the prediction of pathologic response status
![jkms-30-808-i006](/upload/SynapseData/ArticleImage/0063jkms/jkms-30-808-i006.jpg)
Notes
This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2014R1A1A3049554).