Cargando…

The Diagnostic Performance of DCE-MRI in Evaluating the Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer: A Meta-Analysis

Background: Neoadjuvant chemotherapy (NAC) is commonly utilized in preoperative treatment for local breast cancer, and it gives high clinical response rates and can result in pathologic complete response (pCR) in 6–25% of patients. In recent years, dynamic contrast-enhanced magnetic resonance imagin...

Descripción completa

Detalles Bibliográficos
Autores principales: Cheng, Qingqing, Huang, Jiaxi, Liang, Jianye, Ma, Mengjie, Ye, Kunlin, Shi, Changzheng, Luo, Liangping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7028702/
https://www.ncbi.nlm.nih.gov/pubmed/32117747
http://dx.doi.org/10.3389/fonc.2020.00093
_version_ 1783499024287924224
author Cheng, Qingqing
Huang, Jiaxi
Liang, Jianye
Ma, Mengjie
Ye, Kunlin
Shi, Changzheng
Luo, Liangping
author_facet Cheng, Qingqing
Huang, Jiaxi
Liang, Jianye
Ma, Mengjie
Ye, Kunlin
Shi, Changzheng
Luo, Liangping
author_sort Cheng, Qingqing
collection PubMed
description Background: Neoadjuvant chemotherapy (NAC) is commonly utilized in preoperative treatment for local breast cancer, and it gives high clinical response rates and can result in pathologic complete response (pCR) in 6–25% of patients. In recent years, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has been increasingly used to assess the pathological response of breast cancer to NAC. In present analysis, we assess the diagnostic performance of DCE-MRI in evaluating the pathological response of breast cancer to NAC. Materials and Methods: A systematic search in PubMed, the Cochrane Library, and Web of Science for original studies was performed. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess the methodological quality of the included studies. Patient, study, and imaging characteristics were extracted, and sufficient data to reconstruct 2 × 2 tables were obtained. Data pooling, heterogeneity testing, forest plot construction, meta-regression analysis and sensitivity analysis were performed using Stata version 12.0 (StataCorp LP, College Station, TX). Results: Eighteen studies (969 patients with breast cancer) were included in the present meta-analysis. The pooled sensitivity and specificity of DCE-MRI were 0.80 (95% confidence interval [CI]: 0.70, 0.88) and 0.84 (95% [CI]: 0.79, 0.88), respectively. Meta-regression analysis found no significant factors affecting heterogeneity. Sensitivity analysis showed that studies that set pathological complete response (pCR) (n = 14) as a responder showed a tendency for higher sensitivity compared with those that set pCR and near pCR together (n = 5) as a responder (0.83 vs. 0.72), and studies (n = 14) that used DCE-MRI to early predict the pathological response of breast cancer had a higher sensitivity (0.83 vs. 0.71) and equivalent specificity (0.80 vs. 0.86) compared to studies (n = 5) that assessed the response after NAC completion. Conclusion: Our results indicated that DCE-MRI could be considered an important auxiliary method for evaluating the pathological response of breast cancer to NAC and used as an effective method for dynamically monitoring the efficacy during NAC. DCE-MRI also performed well in predicting the pCR of breast cancer to NAC. However, due to the heterogeneity of the included studies, caution should be exercised in applying our results.
format Online
Article
Text
id pubmed-7028702
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-70287022020-02-28 The Diagnostic Performance of DCE-MRI in Evaluating the Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer: A Meta-Analysis Cheng, Qingqing Huang, Jiaxi Liang, Jianye Ma, Mengjie Ye, Kunlin Shi, Changzheng Luo, Liangping Front Oncol Oncology Background: Neoadjuvant chemotherapy (NAC) is commonly utilized in preoperative treatment for local breast cancer, and it gives high clinical response rates and can result in pathologic complete response (pCR) in 6–25% of patients. In recent years, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has been increasingly used to assess the pathological response of breast cancer to NAC. In present analysis, we assess the diagnostic performance of DCE-MRI in evaluating the pathological response of breast cancer to NAC. Materials and Methods: A systematic search in PubMed, the Cochrane Library, and Web of Science for original studies was performed. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess the methodological quality of the included studies. Patient, study, and imaging characteristics were extracted, and sufficient data to reconstruct 2 × 2 tables were obtained. Data pooling, heterogeneity testing, forest plot construction, meta-regression analysis and sensitivity analysis were performed using Stata version 12.0 (StataCorp LP, College Station, TX). Results: Eighteen studies (969 patients with breast cancer) were included in the present meta-analysis. The pooled sensitivity and specificity of DCE-MRI were 0.80 (95% confidence interval [CI]: 0.70, 0.88) and 0.84 (95% [CI]: 0.79, 0.88), respectively. Meta-regression analysis found no significant factors affecting heterogeneity. Sensitivity analysis showed that studies that set pathological complete response (pCR) (n = 14) as a responder showed a tendency for higher sensitivity compared with those that set pCR and near pCR together (n = 5) as a responder (0.83 vs. 0.72), and studies (n = 14) that used DCE-MRI to early predict the pathological response of breast cancer had a higher sensitivity (0.83 vs. 0.71) and equivalent specificity (0.80 vs. 0.86) compared to studies (n = 5) that assessed the response after NAC completion. Conclusion: Our results indicated that DCE-MRI could be considered an important auxiliary method for evaluating the pathological response of breast cancer to NAC and used as an effective method for dynamically monitoring the efficacy during NAC. DCE-MRI also performed well in predicting the pCR of breast cancer to NAC. However, due to the heterogeneity of the included studies, caution should be exercised in applying our results. Frontiers Media S.A. 2020-02-12 /pmc/articles/PMC7028702/ /pubmed/32117747 http://dx.doi.org/10.3389/fonc.2020.00093 Text en Copyright © 2020 Cheng, Huang, Liang, Ma, Ye, Shi and Luo. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Cheng, Qingqing
Huang, Jiaxi
Liang, Jianye
Ma, Mengjie
Ye, Kunlin
Shi, Changzheng
Luo, Liangping
The Diagnostic Performance of DCE-MRI in Evaluating the Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer: A Meta-Analysis
title The Diagnostic Performance of DCE-MRI in Evaluating the Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer: A Meta-Analysis
title_full The Diagnostic Performance of DCE-MRI in Evaluating the Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer: A Meta-Analysis
title_fullStr The Diagnostic Performance of DCE-MRI in Evaluating the Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer: A Meta-Analysis
title_full_unstemmed The Diagnostic Performance of DCE-MRI in Evaluating the Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer: A Meta-Analysis
title_short The Diagnostic Performance of DCE-MRI in Evaluating the Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer: A Meta-Analysis
title_sort diagnostic performance of dce-mri in evaluating the pathological response to neoadjuvant chemotherapy in breast cancer: a meta-analysis
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7028702/
https://www.ncbi.nlm.nih.gov/pubmed/32117747
http://dx.doi.org/10.3389/fonc.2020.00093
work_keys_str_mv AT chengqingqing thediagnosticperformanceofdcemriinevaluatingthepathologicalresponsetoneoadjuvantchemotherapyinbreastcancerametaanalysis
AT huangjiaxi thediagnosticperformanceofdcemriinevaluatingthepathologicalresponsetoneoadjuvantchemotherapyinbreastcancerametaanalysis
AT liangjianye thediagnosticperformanceofdcemriinevaluatingthepathologicalresponsetoneoadjuvantchemotherapyinbreastcancerametaanalysis
AT mamengjie thediagnosticperformanceofdcemriinevaluatingthepathologicalresponsetoneoadjuvantchemotherapyinbreastcancerametaanalysis
AT yekunlin thediagnosticperformanceofdcemriinevaluatingthepathologicalresponsetoneoadjuvantchemotherapyinbreastcancerametaanalysis
AT shichangzheng thediagnosticperformanceofdcemriinevaluatingthepathologicalresponsetoneoadjuvantchemotherapyinbreastcancerametaanalysis
AT luoliangping thediagnosticperformanceofdcemriinevaluatingthepathologicalresponsetoneoadjuvantchemotherapyinbreastcancerametaanalysis
AT chengqingqing diagnosticperformanceofdcemriinevaluatingthepathologicalresponsetoneoadjuvantchemotherapyinbreastcancerametaanalysis
AT huangjiaxi diagnosticperformanceofdcemriinevaluatingthepathologicalresponsetoneoadjuvantchemotherapyinbreastcancerametaanalysis
AT liangjianye diagnosticperformanceofdcemriinevaluatingthepathologicalresponsetoneoadjuvantchemotherapyinbreastcancerametaanalysis
AT mamengjie diagnosticperformanceofdcemriinevaluatingthepathologicalresponsetoneoadjuvantchemotherapyinbreastcancerametaanalysis
AT yekunlin diagnosticperformanceofdcemriinevaluatingthepathologicalresponsetoneoadjuvantchemotherapyinbreastcancerametaanalysis
AT shichangzheng diagnosticperformanceofdcemriinevaluatingthepathologicalresponsetoneoadjuvantchemotherapyinbreastcancerametaanalysis
AT luoliangping diagnosticperformanceofdcemriinevaluatingthepathologicalresponsetoneoadjuvantchemotherapyinbreastcancerametaanalysis