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MRI enhancement in stromal tissue surrounding breast tumors: association with recurrence free survival following neoadjuvant chemotherapy.

Jones EF, Sinha SP, Newitt DC, Klifa C, Kornak J, Park CC, Hylton NM - PLoS ONE (2013)

Bottom Line: Proximity-dependent PE and SER were analyzed using a linear mixed effects model and Cox proportional hazards model for recurrence-free survival.The mixed effects model displayed a decreasing radial trend in PE at both V1 and V2.Survival analysis showed that the hazard ratio estimates for each unit decrease in global SER was statistically significant at V1 [estimated hazard ratio = 0.058, 95% Wald CI (0.003, 1.01), likelihood ratio p = 0.03]; but was not so for V2.

View Article: PubMed Central - PubMed

Affiliation: Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, United States of America. ella.jones@ucsf.edu

ABSTRACT

Rationale and objectives: Normal-appearing stromal tissues surrounding breast tumors can harbor abnormalities that lead to increased risk of local recurrence. The objective of this study was to develop a new imaging methodology to characterize the signal patterns of stromal tissue and to investigate their association with recurrence-free survival following neoadjuvant chemotherapy.

Materials and methods: Fifty patients with locally-advanced breast cancer were imaged with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) before (V1) and after one cycle (V2) of adriamycin-cytoxan therapy. Contrast enhancement in normal-appearing stroma around the tumor was characterized by the mean percent enhancement (PE) and mean signal enhancement ratio (SER) in distance bands of 5 mm from the tumor edge. Global PE and SER were calculated by averaging all stromal bands 5 to 40 mm from tumor. Proximity-dependent PE and SER were analyzed using a linear mixed effects model and Cox proportional hazards model for recurrence-free survival.

Results: The mixed effects model displayed a decreasing radial trend in PE at both V1 and V2. An increasing trend was less pronounced in SER. Survival analysis showed that the hazard ratio estimates for each unit decrease in global SER was statistically significant at V1 [estimated hazard ratio = 0.058, 95% Wald CI (0.003, 1.01), likelihood ratio p = 0.03]; but was not so for V2.

Conclusions: These findings show that stromal tissue outside the tumor can be quantitatively characterized by DCE-MRI, and suggest that stromal enhancement measurements may be further developed for use as a potential predictor of recurrence/disease-free survival following therapy.

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pone-0061969-g001: Patient inclusion/exclusion flow chart.

Mentions: All patients underwent dynamic contrast-enhanced (DCE) MRI before chemotherapy (V1), and 50 patients were scanned after one cycle of chemotherapy (V2) (Figure 1). Recurrence-free survival (RFS) was assessed for each patient based on the absence of palpable mass by clinical examination and suspicious lesion by mammographic imaging (at 6-month or 1-year intervals) following surgery and recurrence categorized as local or distant. The length of RFS was defined as the time from initial surgery to either local or distant recurrence or the time to the last follow-up in patients without evidence of recurrence. Lesion characteristics such as pretreatment tumor size measured by volume, tumor longest diameter and pathology, nodal involvement and Scharff-Bloom-Richardson (SBR) grading were recorded.


MRI enhancement in stromal tissue surrounding breast tumors: association with recurrence free survival following neoadjuvant chemotherapy.

Jones EF, Sinha SP, Newitt DC, Klifa C, Kornak J, Park CC, Hylton NM - PLoS ONE (2013)

Patient inclusion/exclusion flow chart.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3646993&req=5

pone-0061969-g001: Patient inclusion/exclusion flow chart.
Mentions: All patients underwent dynamic contrast-enhanced (DCE) MRI before chemotherapy (V1), and 50 patients were scanned after one cycle of chemotherapy (V2) (Figure 1). Recurrence-free survival (RFS) was assessed for each patient based on the absence of palpable mass by clinical examination and suspicious lesion by mammographic imaging (at 6-month or 1-year intervals) following surgery and recurrence categorized as local or distant. The length of RFS was defined as the time from initial surgery to either local or distant recurrence or the time to the last follow-up in patients without evidence of recurrence. Lesion characteristics such as pretreatment tumor size measured by volume, tumor longest diameter and pathology, nodal involvement and Scharff-Bloom-Richardson (SBR) grading were recorded.

Bottom Line: Proximity-dependent PE and SER were analyzed using a linear mixed effects model and Cox proportional hazards model for recurrence-free survival.The mixed effects model displayed a decreasing radial trend in PE at both V1 and V2.Survival analysis showed that the hazard ratio estimates for each unit decrease in global SER was statistically significant at V1 [estimated hazard ratio = 0.058, 95% Wald CI (0.003, 1.01), likelihood ratio p = 0.03]; but was not so for V2.

View Article: PubMed Central - PubMed

Affiliation: Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, United States of America. ella.jones@ucsf.edu

ABSTRACT

Rationale and objectives: Normal-appearing stromal tissues surrounding breast tumors can harbor abnormalities that lead to increased risk of local recurrence. The objective of this study was to develop a new imaging methodology to characterize the signal patterns of stromal tissue and to investigate their association with recurrence-free survival following neoadjuvant chemotherapy.

Materials and methods: Fifty patients with locally-advanced breast cancer were imaged with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) before (V1) and after one cycle (V2) of adriamycin-cytoxan therapy. Contrast enhancement in normal-appearing stroma around the tumor was characterized by the mean percent enhancement (PE) and mean signal enhancement ratio (SER) in distance bands of 5 mm from the tumor edge. Global PE and SER were calculated by averaging all stromal bands 5 to 40 mm from tumor. Proximity-dependent PE and SER were analyzed using a linear mixed effects model and Cox proportional hazards model for recurrence-free survival.

Results: The mixed effects model displayed a decreasing radial trend in PE at both V1 and V2. An increasing trend was less pronounced in SER. Survival analysis showed that the hazard ratio estimates for each unit decrease in global SER was statistically significant at V1 [estimated hazard ratio = 0.058, 95% Wald CI (0.003, 1.01), likelihood ratio p = 0.03]; but was not so for V2.

Conclusions: These findings show that stromal tissue outside the tumor can be quantitatively characterized by DCE-MRI, and suggest that stromal enhancement measurements may be further developed for use as a potential predictor of recurrence/disease-free survival following therapy.

Show MeSH
Related in: MedlinePlus