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Evaluating pCR after neoadjuvant systemic treatment of invasive breast cancer using DWI in comparison to DCE-based kinetic analysis

Rie Ota¹, Masako Kataoka¹, Maya Honda¹, Mami Iima¹, Kanae Kwai Miyake¹, Akane Ohashi², Yosuke Yamada³, Masakazu Toi⁴, and Yuji Nakamoto¹
¹Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University graduate school of medicine, Kyoto, Japan, ²Kyoto Medical Center, Kyoto, Japan, ³Department of Pathology, Kyoto University Hospital, Kyoto, Japan, ⁴Department of Breast Surgery, Kyoto University Hospital, Kyoto, Japan

DWI-based scoring system can be used to evaluate pCR with diagnostic performance similar to that in kinetic analysis, particularly in triple negative subtypes.

-ROC analysis for diagnosing pCR based on DWI score/Kinetic score-

Kinetic score showed slightly higher AUC while 95% confidence interval overlapped with that of DWI score. Both kinetic score and DWI score demonstrated excellent diagnostic performance among triple negative subtype compared to other subtype with AUC of 0.88-0.95. For luminal subtype, DWI score tended to perform better than kinetic score.

-Image evaluation-

DWI score

DWI of the target lesion was evaluated and categorized as 3-point scale.

0: no abnormal signal, 1: small focus of high - intermediate signal intensity, 2: obvious high signal intensity.

Kinetic score

Kinetic patterns of the lesions on DCE-MRI was scored as

0 : no enhancement, 1 : persistent, 2 : plateau and 3 : washout.

For both scores Low score indicates pCR.