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| Intravoxel incoherent motion imaging in evaluating the response of breast cancers to the neoadjuvant chemotherapy |
| LV Guang-jie, GAO Jia-yin, XU Zhu-jin, HUA Bin, CHEN Min, JIANG Lei |
| Graduate School of Peking Union Medical College, Beijing Hospital, National Center of Gerontology, Beijing 100730, China |
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Abstract Objective: To assess the value of intravoxel incoherent motion(IVIM) in evaluating the response of breast cancers to the neoadjuvant chemotherapy(NAC). Methods: Sixty patients with 61 lesions, who underwent neoadjuvant chemotherapy and subsequent surgery, were prospectively recruited. All patients underwent MRI(including IVIM imaging) for three times: before NAC(T1), after the first course of NAC(T2) and after NAC(T3). The values of apparent diffusion coefficient(ADC), pure diffusion coefficient(D), pseudo-diffusion coefficient(D*) and perfusion fraction(f) were measured. According to Miller-Payne grading of pathology from surgery, patients were divided into good(R group) and mild response group(NR group). The t test of two independent samples and Mann-Whitney U test were used to compare the parameters at the three time points between groups and to compare the T2~T1 parameter difference(△ADC, △D*, △D, △f) between groups. The paired sample t test and Wilcoxon rank sum test were used to compare the parameters from T2 or T3 with those from T1, respectively. For parameters with statistically significant inter-group difference, ROC analysis was used. Results: There were 21 cases in the R group and 40 cases in NR group. At T2, the f value of R group was significantly lower than that of NR group(P=0.027); however, ADC and D values had no significant difference between groups. At T3, ADC and D values of R group were significantly higher than those of NR(P=0.002, 0.000, respectively); the f value of R group was significantly lower than that of NR(P=0.000). D* values showed no inter-group difference at both T2 and T3. The difference of △D, △f values between groups were statistically significant(P=0.001, 0.000, respectively), however, △ADC and △D* were not statistically different between groups. Further intra-group comparison showed that f, D and ADC value of the R group were significantly changed, no matter at T2 or T3, compared with T1; However, in NR group, only the D value at T3 significantly changed when compared with T1(P=0.010). The areas under the ROC curve of f, △f and △D value were 0.673, 0.788, 0.753, with no significant difference among them. Conclusions: IVIM may be a useful adjunctive tool in evaluating the response of tumors to NAC. The f and D, especially f, have the potential of both early prediction and end-NAC evaluation, while ADC is helpful only in end-NAC evaluation. However, D* has no value.
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Received: 24 January 2019
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