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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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Stromal enhancement pattern of SER in recurrent and non-recurrent patients.Stromal enhancement pattern of SER in recurrent and non-recurrent cohorts at V1 and V2 (based on a 5-year cut-off). The red line shows the trending of SER. At V1: there was no observable trend for recurrent group (a) but an increasing trend of stromal SER outside of tumor was observed in the non-current group (b). At V2: No observable trend was found in the recurrent group (c), but a slight increasing trend was found in the non-recurrent group (d).
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pone-0061969-g005: Stromal enhancement pattern of SER in recurrent and non-recurrent patients.Stromal enhancement pattern of SER in recurrent and non-recurrent cohorts at V1 and V2 (based on a 5-year cut-off). The red line shows the trending of SER. At V1: there was no observable trend for recurrent group (a) but an increasing trend of stromal SER outside of tumor was observed in the non-current group (b). At V2: No observable trend was found in the recurrent group (c), but a slight increasing trend was found in the non-recurrent group (d).

Mentions: When the recurrence status was added as a group variable to the mixed effects model, SER showed a slight (but not statistically significant) increasing trend in both non-recurrent (V1: 0.0025, 95% CI (−0.0017, 0.0067), p = 0.3; V2: 0.0023, 95% CI (−0.0018, 0.0064), p = 0.3) and recurrent groups (V1: 0.0009, 95% CI (−0.0046, 0.0064), p = 0.8; V2: 0.0031, 95% CI (−0.0026, 0.0089), p = 0.3) (Figure 5). There was no evidence of a difference in pattern in non-recurrent versus recurrent groups with estimated differences (recurrent minus non-recurrent) in slopes close to zero, though the confidence intervals were wide: (V1: −0.0016, 95% CI (−0.0085, 0.0053), p = 0.7; V2: 0.0008, 95% CI (−0.0063, 0.0078), p = 0.9). Finally, when examining difference in distance effects related to recurrent and non-recurrent groups, there were no statistically significant results to report and confidence intervals were too wide to make any conclusions with respect to negative results.


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)

Stromal enhancement pattern of SER in recurrent and non-recurrent patients.Stromal enhancement pattern of SER in recurrent and non-recurrent cohorts at V1 and V2 (based on a 5-year cut-off). The red line shows the trending of SER. At V1: there was no observable trend for recurrent group (a) but an increasing trend of stromal SER outside of tumor was observed in the non-current group (b). At V2: No observable trend was found in the recurrent group (c), but a slight increasing trend was found in the non-recurrent group (d).
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3646993&req=5

pone-0061969-g005: Stromal enhancement pattern of SER in recurrent and non-recurrent patients.Stromal enhancement pattern of SER in recurrent and non-recurrent cohorts at V1 and V2 (based on a 5-year cut-off). The red line shows the trending of SER. At V1: there was no observable trend for recurrent group (a) but an increasing trend of stromal SER outside of tumor was observed in the non-current group (b). At V2: No observable trend was found in the recurrent group (c), but a slight increasing trend was found in the non-recurrent group (d).
Mentions: When the recurrence status was added as a group variable to the mixed effects model, SER showed a slight (but not statistically significant) increasing trend in both non-recurrent (V1: 0.0025, 95% CI (−0.0017, 0.0067), p = 0.3; V2: 0.0023, 95% CI (−0.0018, 0.0064), p = 0.3) and recurrent groups (V1: 0.0009, 95% CI (−0.0046, 0.0064), p = 0.8; V2: 0.0031, 95% CI (−0.0026, 0.0089), p = 0.3) (Figure 5). There was no evidence of a difference in pattern in non-recurrent versus recurrent groups with estimated differences (recurrent minus non-recurrent) in slopes close to zero, though the confidence intervals were wide: (V1: −0.0016, 95% CI (−0.0085, 0.0053), p = 0.7; V2: 0.0008, 95% CI (−0.0063, 0.0078), p = 0.9). Finally, when examining difference in distance effects related to recurrent and non-recurrent groups, there were no statistically significant results to report and confidence intervals were too wide to make any conclusions with respect to negative results.

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