Prognostic value of pretreatment dynamic contrast-enhanced MR imaging in breast cancer patients receiving neoadjuvant chemotherapy: Overall survival predicted from combined time course and volume analysis

<jats:p> Background: The prognostic value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in breast cancer has been explored, and the results are promising. </jats:p><jats:p> Purpose: To investigate the possible correlation between pretreatment DCE-MRI and overall survival 5 years after diagnosis in breast cancer patients receiving neoadjuvant chemotherapy (NAC) using combined time course analysis and volume measurement from DCE-MRI data acquired with 1 min temporal resolution. </jats:p><jats:p> Material and Methods: Pretreatment DCE-MR images of 32 female patients were examined. The total enhancing volume was calculated by including the voxels with >60% signal enhancing 1 min postcontrast. The signal intensity time course data were automatically classified on a voxel-by-voxel basis according to the enhancing characteristics: persistent (type I), plateau (type II) or washout (type III), and the resulting volumes of each enhancement type were calculated. </jats:p><jats:p> Results: A significant correlation between total enhancing volume and 5-year survival was found, P=0.05 (log-rank). The survival was 51 ±15 months (mean ±95% confidence intervals (CI)) and 73±12 months in patients with a total enhancing volume >41 cm<jats:sup>3</jats:sup> and ≤41 cm<jats:sup>3</jats:sup>, respectively. A two-dimensional discriminator, taking both total enhancing volume and type III enhancing volume into account, improved the prediction of survival, resulting in a P value (log-rank) between survivors and non-survivors of <0.001. The survival was 44±16 months (mean ±95% CI) and 74±11 months in patients with a total enhancing volume >58 cm<jats:sup>3</jats:sup> and/or a type III volume >8 cm<jats:sup>3</jats:sup>, and ≤58 cm<jats:sup>3</jats:sup> and ≤8 cm<jats:sup>3</jats:sup>, respectively. </jats:p><jats:p> Conclusion: Pretreatment DCE-MRI might help in predicting prognosis in breast cancer patients receiving NAC. </jats:p>