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Impact of Alternate b-Value Combinations and Metrics on the Predictive Performance and Repeatability of Diffusion-Weighted MRI in Breast Cancer Treatment: Results from the ECOG-ACRIN A6698 Trial
In diffusion-weighted MRI (DW-MRI), choice of b-value influences apparent diffusion coefficient (ADC) values by probing different aspects of the tissue microenvironment. As a secondary analysis of the multicenter ECOG-ACRIN A6698 trial, the purpose of this study was to investigate the impact of alte...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8938828/ https://www.ncbi.nlm.nih.gov/pubmed/35314635 http://dx.doi.org/10.3390/tomography8020058 |
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author | Partridge, Savannah C. Steingrimsson, Jon Newitt, David C. Gibbs, Jessica E. Marques, Helga S. Bolan, Patrick J. Boss, Michael A. Chenevert, Thomas L. Rosen, Mark A. Hylton, Nola M. |
author_facet | Partridge, Savannah C. Steingrimsson, Jon Newitt, David C. Gibbs, Jessica E. Marques, Helga S. Bolan, Patrick J. Boss, Michael A. Chenevert, Thomas L. Rosen, Mark A. Hylton, Nola M. |
author_sort | Partridge, Savannah C. |
collection | PubMed |
description | In diffusion-weighted MRI (DW-MRI), choice of b-value influences apparent diffusion coefficient (ADC) values by probing different aspects of the tissue microenvironment. As a secondary analysis of the multicenter ECOG-ACRIN A6698 trial, the purpose of this study was to investigate the impact of alternate b-value combinations on the performance and repeatability of tumor ADC as a predictive marker of breast cancer treatment response. The final analysis included 210 women who underwent standardized 4-b-value DW-MRI (b = 0/100/600/800 s/mm(2)) at multiple timepoints during neoadjuvant chemotherapy treatment and a subset (n = 71) who underwent test–retest scans. Centralized tumor ADC and perfusion fraction (f(p)) measures were performed using variable b-value combinations. Prediction of pathologic complete response (pCR) based on the mid-treatment/12-week percent change in each metric was estimated by area under the receiver operating characteristic curve (AUC). Repeatability was estimated by within-subject coefficient of variation (wCV). Results show that two-b-value ADC calculations provided non-inferior predictive value to four-b-value ADC calculations overall (AUCs = 0.60–0.61 versus AUC = 0.60) and for HR+/HER2− cancers where ADC was most predictive (AUCs = 0.75–0.78 versus AUC = 0.76), p < 0.05. Using two b-values (0/600 or 0/800 s/mm(2)) did not reduce ADC repeatability over the four-b-value calculation (wCVs = 4.9–5.2% versus 5.4%). The alternate metrics ADC(fast) (b ≤ 100 s/mm(2)), ADC(slow) (b ≥ 100 s/mm(2)), and f(p) did not improve predictive performance (AUCs = 0.54–0.60, p = 0.08–0.81), and ADC(fast) and f(p) demonstrated the lowest repeatability (wCVs = 6.71% and 12.4%, respectively). In conclusion, breast tumor ADC calculated using a simple two-b-value approach can provide comparable predictive value and repeatability to full four-b-value measurements as a marker of treatment response. |
format | Online Article Text |
id | pubmed-8938828 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-89388282022-03-23 Impact of Alternate b-Value Combinations and Metrics on the Predictive Performance and Repeatability of Diffusion-Weighted MRI in Breast Cancer Treatment: Results from the ECOG-ACRIN A6698 Trial Partridge, Savannah C. Steingrimsson, Jon Newitt, David C. Gibbs, Jessica E. Marques, Helga S. Bolan, Patrick J. Boss, Michael A. Chenevert, Thomas L. Rosen, Mark A. Hylton, Nola M. Tomography Article In diffusion-weighted MRI (DW-MRI), choice of b-value influences apparent diffusion coefficient (ADC) values by probing different aspects of the tissue microenvironment. As a secondary analysis of the multicenter ECOG-ACRIN A6698 trial, the purpose of this study was to investigate the impact of alternate b-value combinations on the performance and repeatability of tumor ADC as a predictive marker of breast cancer treatment response. The final analysis included 210 women who underwent standardized 4-b-value DW-MRI (b = 0/100/600/800 s/mm(2)) at multiple timepoints during neoadjuvant chemotherapy treatment and a subset (n = 71) who underwent test–retest scans. Centralized tumor ADC and perfusion fraction (f(p)) measures were performed using variable b-value combinations. Prediction of pathologic complete response (pCR) based on the mid-treatment/12-week percent change in each metric was estimated by area under the receiver operating characteristic curve (AUC). Repeatability was estimated by within-subject coefficient of variation (wCV). Results show that two-b-value ADC calculations provided non-inferior predictive value to four-b-value ADC calculations overall (AUCs = 0.60–0.61 versus AUC = 0.60) and for HR+/HER2− cancers where ADC was most predictive (AUCs = 0.75–0.78 versus AUC = 0.76), p < 0.05. Using two b-values (0/600 or 0/800 s/mm(2)) did not reduce ADC repeatability over the four-b-value calculation (wCVs = 4.9–5.2% versus 5.4%). The alternate metrics ADC(fast) (b ≤ 100 s/mm(2)), ADC(slow) (b ≥ 100 s/mm(2)), and f(p) did not improve predictive performance (AUCs = 0.54–0.60, p = 0.08–0.81), and ADC(fast) and f(p) demonstrated the lowest repeatability (wCVs = 6.71% and 12.4%, respectively). In conclusion, breast tumor ADC calculated using a simple two-b-value approach can provide comparable predictive value and repeatability to full four-b-value measurements as a marker of treatment response. MDPI 2022-03-04 /pmc/articles/PMC8938828/ /pubmed/35314635 http://dx.doi.org/10.3390/tomography8020058 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Partridge, Savannah C. Steingrimsson, Jon Newitt, David C. Gibbs, Jessica E. Marques, Helga S. Bolan, Patrick J. Boss, Michael A. Chenevert, Thomas L. Rosen, Mark A. Hylton, Nola M. Impact of Alternate b-Value Combinations and Metrics on the Predictive Performance and Repeatability of Diffusion-Weighted MRI in Breast Cancer Treatment: Results from the ECOG-ACRIN A6698 Trial |
title | Impact of Alternate b-Value Combinations and Metrics on the Predictive Performance and Repeatability of Diffusion-Weighted MRI in Breast Cancer Treatment: Results from the ECOG-ACRIN A6698 Trial |
title_full | Impact of Alternate b-Value Combinations and Metrics on the Predictive Performance and Repeatability of Diffusion-Weighted MRI in Breast Cancer Treatment: Results from the ECOG-ACRIN A6698 Trial |
title_fullStr | Impact of Alternate b-Value Combinations and Metrics on the Predictive Performance and Repeatability of Diffusion-Weighted MRI in Breast Cancer Treatment: Results from the ECOG-ACRIN A6698 Trial |
title_full_unstemmed | Impact of Alternate b-Value Combinations and Metrics on the Predictive Performance and Repeatability of Diffusion-Weighted MRI in Breast Cancer Treatment: Results from the ECOG-ACRIN A6698 Trial |
title_short | Impact of Alternate b-Value Combinations and Metrics on the Predictive Performance and Repeatability of Diffusion-Weighted MRI in Breast Cancer Treatment: Results from the ECOG-ACRIN A6698 Trial |
title_sort | impact of alternate b-value combinations and metrics on the predictive performance and repeatability of diffusion-weighted mri in breast cancer treatment: results from the ecog-acrin a6698 trial |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8938828/ https://www.ncbi.nlm.nih.gov/pubmed/35314635 http://dx.doi.org/10.3390/tomography8020058 |
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