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Updated: Sep 20, 2025
Tracking the Mammary Architectural Features and Detecting Breast Cancer with Magnetic Resonance Diffusion Tensor Imaging
Published on: December 15, 2014
Evaluation of pathological complete response after neoadjuvant systemic treatment of invasive breast cancer using
Rie Ota1, Masako Kataoka2, Mami Iima3
1Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine Kyoto University, Kyoto, Japan; Department of Radiology, Tenri Hospital, Nara, Japan.
Purpose:
This study compared the performance of diffusion-weighted imaging (DWI) to dynamic contrast-enhanced (DCE)-MRI for diagnosing pathological complete response (pCR) before surgery.
Method:
Overall, 133 lesions from 133 patients who underwent pre-surgical MRI evaluation after neoadjuvant systemic treatment were included. Two readers blinded to the pathological diagnosis evaluated the images. MR images were obtained using a routine protocol sequence that included DWI and DCE-MRI. DWI of the target lesion was scored using a three-point scale. Kinetic patterns of lesions on DCE-MRI were scored using a four-point scale. The capacities of DWI and kinetic parameters for discriminating pCR and non-pCR were assessed via receiver operating characteristic (ROC) analysis.
Results:
For DWI scores, ROC analysis showed areas under the ROC curve (AUCs) of 0.84 (95% confidence interval: 0.77-0.90) and 0.85 (0.77-0.90) for readers 1 and 2, respectively; corresponding AUCs of kinetic scores were 0.89 (0.82-0.94) and 0.88 (0.81-0.93). Among the triple-negative subtype, the AUCs of DWI scores were 0.84 (0.70-0.93) and 0.88 (0.75-0.96) for readers 1 and 2, respectively; corresponding AUCs of kinetic scores were 0.94 (0.83-0.99) and 0.93 (0.82-0.99). Among the luminal subtype, the AUCs of DWI scores were 0.85 (0.71-0.94) and 0.82 (0.68-0.92) for readers 1 and 2, respectively; corresponding AUCs of kinetic scores were 0.82 (0.68-0.92) and 0.72 (0.56-0.85).
Conclusions:
Our DWI-based visual score and kinetic score showed similar diagnostic performances. Both DWI and kinetic scores tended to perform better in predicting pCR for the triple-negative subtype.
