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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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Radial trend of PE in recurrent and non-recurrent patients.Radial trends of PE values in recurrent and non-recurrent groups (based on a 5-year cut off) were shown here over a distance of 5 to 40 mm from the tumor edge. A decreasing trend (shown in red trend line) of PE was observed in all cases (3a–d).
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pone-0061969-g004: Radial trend of PE in recurrent and non-recurrent patients.Radial trends of PE values in recurrent and non-recurrent groups (based on a 5-year cut off) were shown here over a distance of 5 to 40 mm from the tumor edge. A decreasing trend (shown in red trend line) of PE was observed in all cases (3a–d).

Mentions: When the recurrence status was added as a group variable to the mixed effects model, PE exhibited the same decreasing radial trend in both recurrent and non-recurrent groups at V1 and V2 (Figure 4). At V1, the estimated mean PE change per mm in the non-recurrent group was -0.416, 95% CI (−0.572, −0.259), p<0.0001 and in the recurrent group was −0.453, 95% CI (−0.648, −0.257), p<0.0001. The estimated difference in distance effects between the two groups (recurrent minus non-recurrent) was negative but small (the recurrence group having greater decline with distance) and with a wide confidence interval (−0.037, 95% CI (−0.288, 0.213), p = 0.8). At V2, the estimated mean PE change per mm in the non-recurrent group was −0.502, 95% CI (−0.809, −0.195), p = 0.002, but in the recurrent group was estimated as −0.148, 95% CI (−0.564, 0.268), p <0.5. The estimated difference between the slopes (with respect to radial distance) of the two groups was positive, but with a wide confidence interval (0.354, 95% CI (−0.163, 0.872), p = 0.2).


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)

Radial trend of PE in recurrent and non-recurrent patients.Radial trends of PE values in recurrent and non-recurrent groups (based on a 5-year cut off) were shown here over a distance of 5 to 40 mm from the tumor edge. A decreasing trend (shown in red trend line) of PE was observed in all cases (3a–d).
© Copyright Policy
Related In: Results  -  Collection

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

pone-0061969-g004: Radial trend of PE in recurrent and non-recurrent patients.Radial trends of PE values in recurrent and non-recurrent groups (based on a 5-year cut off) were shown here over a distance of 5 to 40 mm from the tumor edge. A decreasing trend (shown in red trend line) of PE was observed in all cases (3a–d).
Mentions: When the recurrence status was added as a group variable to the mixed effects model, PE exhibited the same decreasing radial trend in both recurrent and non-recurrent groups at V1 and V2 (Figure 4). At V1, the estimated mean PE change per mm in the non-recurrent group was -0.416, 95% CI (−0.572, −0.259), p<0.0001 and in the recurrent group was −0.453, 95% CI (−0.648, −0.257), p<0.0001. The estimated difference in distance effects between the two groups (recurrent minus non-recurrent) was negative but small (the recurrence group having greater decline with distance) and with a wide confidence interval (−0.037, 95% CI (−0.288, 0.213), p = 0.8). At V2, the estimated mean PE change per mm in the non-recurrent group was −0.502, 95% CI (−0.809, −0.195), p = 0.002, but in the recurrent group was estimated as −0.148, 95% CI (−0.564, 0.268), p <0.5. The estimated difference between the slopes (with respect to radial distance) of the two groups was positive, but with a wide confidence interval (0.354, 95% CI (−0.163, 0.872), p = 0.2).

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