Magnetic resonance imaging and ultrasound for prediction of residual tumor size in early breast cancer within the ADAPT subtrials

Breast Cancer Research

Jascha Adams¹  Lale Umutlu²  Christiane K. Kuhl³  Simone Schrading³  Kevin Strobel³  Bahriye Aktas⁴  Alex Frydrychowicz⁵  Anna Prange⁶  Dorothea Rjosk-Dendorfer⁷  Henrik Nitzsche⁸  Raquel von Schumann⁸  Jochem Potenberg⁹  Ralph Culemann^1,10  Helmut Forstbauer^1,11  Christopher Herzog^1,12  Michael Braun^1,13  Eva-Maria Grischke^1,14  Cornelia Kolberg-Liedtke^1,15  Christine Eulenburg^1,16  Sherko Kümmel^1,17  Rachel Würstlein^1,18  Nadia Harbeck^1,18  Ulrike Nitz^1,19  Monika Graeser^2,20  Oleg Gluz^2,21 

[1] Alcedis GmbH, Winchesterstrasse 3, 35394, Giessen, Germany;Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany;Department of Diagnostic and Interventional Radiology, Hospital of the University of Aachen, RWTH, Pauwelsstrasse 30, 52074, Aachen, Germany;Department of Gynecology and Obstetrics, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany;Department of Gynecology, University Hospital Leipzig, Liebeigstrasse 20A, 04103, Leipzig, Germany;Department of Radiology and Nuclear Medicine, Schleswig-Holstein University Hospital, Campus Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany;Department of Radiology, Clinics Essen-Mitte, Breast Centre, Henricistrasse 92, 45136, Essen, Germany;Department of Radiology, University Hospital, LMU Munich, Marchioninistrasse. 15, 81377, Munich, Germany;Ev. Hospital Bethesda, Breast Center Niederrhein, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany;Ev. Waldkrankenhaus Berlin, Stadtrandstrasse 555, 13589, Berlin, Germany;Medizinisches Versorgungszentrum Radiologie Rhein-Sieg, GFO Kliniken Troisdorf, Hospitalstrasse 45, 53840, Troisdorf, Germany;Practice Network Troisdorf, Schlossstrasse 18, 53840, Troisdorf, Germany;Radiology, Burgstrasse 7, 80331, Munich, Germany;Red Cross Women’s Hospital, Nymphenburger Strasse 163, 80634, Munich, Germany;University Clinic Tuebingen, Women’s Clinic, Calwerstrasse 7, 72076, Tuebingen, Germany;University Hospital Charité, Women’s Clinic, Berlin, Charitéplatz 1, 10117, Berlin, Germany;Department of Gynecology and Obstetrics, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany;West German Study Group, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany;West German Study Group, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany;Clinics Essen-Mitte, Breast Centre, Henricistrasse 92, 45136, Essen, Germany;University Hospital Charité, Women’s Clinic, Berlin, Charitéplatz 1, 10117, Berlin, Germany;West German Study Group, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany;Department of Gynecology and Obstetrics, Breast Center, University of Munich (LMU) and CCCLMU, Marchioninistrasse 15, 81377, Munich, Germany;West German Study Group, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany;Ev. Hospital Bethesda, Breast Center Niederrhein, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany;West German Study Group, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany;Ev. Hospital Bethesda, Breast Center Niederrhein, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany;Department of Gynecology, University Medical Center Hamburg, Martinistrasse 52, 20251, Hamburg, Germany;West German Study Group, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany;Ev. Hospital Bethesda, Breast Center Niederrhein, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany;University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany;

关键词: Breast cancer;    Neoadjuvant therapy;    Magnetic resonance imaging;    Ultrasound;    Residual tumor size;   

DOI  :  10.1186/s13058-021-01413-y

来源: Springer

【 摘 要 】

BackgroundPrediction of histological tumor size by post-neoadjuvant therapy (NAT) ultrasound and magnetic resonance imaging (MRI) was evaluated in different breast cancer subtypes.MethodsImaging was performed after 12-week NAT in patients enrolled into three neoadjuvant WSG ADAPT subtrials. Imaging performance was analyzed for prediction of residual tumor measuring ≤10 mm and summarized using positive (PPV) and negative (NPV) predictive values.ResultsA total of 248 and 588 patients had MRI and ultrasound, respectively. Tumor size was over- or underestimated by < 10 mm in 4.4% and 21.8% of patients by MRI and in 10.2% and 15.8% by ultrasound. Overall, NPV (proportion of correctly predicted tumor size ≤10 mm) of MRI and ultrasound was 0.92 and 0.83; PPV (correctly predicted tumor size > 10 mm) was 0.52 and 0.61. MRI demonstrated a higher NPV and lower PPV than ultrasound in hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-positive and in HR−/HER2+ tumors. Both methods had a comparable NPV and PPV in HR−/HER2− tumors.ConclusionsIn HR+/HER2+ and HR−/HER2+ breast cancer, MRI is less likely than ultrasound to underestimate while ultrasound is associated with a lower risk to overestimate tumor size. These findings may help to select the most optimal imaging approach for planning surgery after NAT.Trial registrationClinicaltrials.gov, NCT01815242 (registered on March 21, 2013), NCT01817452 (registered on March 25, 2013), and NCT01779206 (registered on January 30, 2013).

【 授权许可】

CC BY