Observational studyEuropean radiology2024
Diffusion-weighted imaging in addition to contrast-enhanced MRI in identifying complete response in HER2-positive breast cancer.
Observational study in European radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Incremental Value of Synthetic MRI Radiomics in Predicting Neoadjuvant Response in Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer.Radiology. Imaging cancer · 2026Article
- Comparison of [European journal of nuclear medicine and molecular imaging · 2026Article
- A Practical Machine Learning Model for Predicting Neoadjuvant Response in HER2-Positive Breast Cancer.Diagnostics (Basel, Switzerland) · 2026Article
- The role of radiomics in predicting the response to neoadjuvant chemotherapy for breast cancer.Cancer biology & medicine · 2026Review
- Research on Omitting Sentinel Lymph Node Biopsy after Neoadjuvant Therapy in cN1 Breast Cancer Patients.Cancer medicine · 2026Article
- Advancing breast cancer diagnosis: a combined approach using deep learning-reconstructed diffusion-weighted imaging and Synthetic MRI.Frontiers in oncology · 2026Article
- Early MRI-Derived Volumetric Thresholds Predict Response and Guide Personalization in HER2-Positive Breast Cancer: A Retrospective Study.Biomedicines · 2025Article
- Monitoring Pharmacological Treatment of Breast Cancer with MRI.Current issues in molecular biology · 2025Review
- Early Tumor Shrinkage and Depth of Response as Predictive Markers of Treatment Response and Prognosis in Solid Tumors.Cancer medicine · 2025Review
- Longitudinal MRI-Driven Multi-Modality Approach for Predicting Pathological Complete Response and B Cell Infiltration in Breast Cancer.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Article
- Assessment of the efficacy of various neoadjuvant anti-HER2 targeted therapies combined with chemotherapy for HER2-positive breast cancer in the real-world setting and development of a predictive model for pathological complete response.Frontiers in oncology · 2025Article
- Omitting sentinel lymph node biopsy in early breast cancer: too bold or the future?Translational breast cancer research : a journal focusing on translational research in breast cancer · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe aim of this study is to investigate the added value of diffusion-weighted imaging (DWI) to dynamic-contrast enhanced (DCE)-MRI to identify a pathological complete response (pCR) in patients with HER2-positive breast cancer and radiological complete response (rCR). MATERIALS AND
methodsThis is a single-center observational study of 102 patients with stage I-III HER2-positive breast cancer and real-world documented rCR on DCE-MRI. Patients were treated between 2015 and 2019. Both 1.5 T/3.0 T single-shot diffusion-weighted echo-planar sequence were used. Post neoadjuvant systemic treatment (NST) diffusion-weighted images were reviewed by two readers for visual evaluation and ADCmean. Discordant cases were resolved in a consensus meeting. pCR of the breast (ypT0/is) was used to calculate the negative predictive value (NPV). Breast pCR-percentages were tested with Fisher's exact test. ADCmean and ∆ADCmean(%) for patients with and without pCR were compared using a Mann-Whitney U-test.
resultsThe NPV for DWI added to DCE is 86% compared to 87% for DCE alone in hormone receptor (HR)-/HER2-positive and 67% compared to 64% in HR-positive/HER2-positive breast cancer. Twenty-seven of 39 non-rCR DWI cases were false positives. In HR-positive/HER2-positive breast cancer the NPV for DCE MRI differs between MRI field strength (1.5 T: 50% vs. 3 T: 81% [p = 0.02]). ADCmean at baseline, post-NST, and ∆ADCmean were similar between patients with and without pCR.
conclusionDWI has no clinically relevant effect on the NPV of DCE alone to identify a pCR in early HER2-positive breast cancer. The added value of DWI in HR-positive/HER2-positive breast cancer should be further investigated taken MRI field strength into account. CLINICAL RELEVANCE STATEMENT: The residual signal on DWI after neoadjuvant systemic therapy in cases with early HER2-positive breast cancer and no residual pathologic enhancement on DCE-MRI breast should not (yet) be considered in assessing a complete radiologic response. KEY POINTS: Radiologic complete response is associated with a pathologic complete response (pCR) in HER2+ breast cancer but further improvement is warranted. No relevant increase in negative predictive value was observed when DWI was added to DCE. Residual signal on DW-images without pathologic enhancement on DCE-MRI, does not indicate a lower chance of pCR.
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