ArticleJournal of applied clinical medical physics2026
K-means clustering-based analysis of quantitative ultrafast DCE-MRI for predicting breast cancer response to neoadjuvant chemotherapy.
Article in Journal of applied clinical medical physics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- K-means clustering-based analysis of quantitative ultrafast DCE-MRI for predicting breast cancer response to neoadjuvant chemotherapy.Journal of applied clinical medical physics · 2026Article
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10 authors.
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Abstract
purposeAchieving a pathologic complete response (pCR) following neoadjuvant chemotherapy (NAC) is strongly associated with improved survival. This study investigates whether bilateral asymmetry of quantitative perfusion parameters in normal parenchyma from ultrafast dynamic contrast-enhanced MRI (DCE-MRI), measured using k-means clustering (KMC) before NAC, can predict pCR in breast cancer patients. MATERIALS AND
methodsFifty-six breast cancer patients undergoing NAC with pretreatment ultrafast DCE-MRI (3-9 s/image at 3T) were enrolled. KMC was used to classify tumor and normal parenchymal voxels into five clusters based on maximum enhancement rate (A·α). Ipsilateral-to-contralateral (I/C) ratios of background parenchymal enhancement kinetics (kBPE) and tumor kinetics (kT) were compared between pCR and nonpCR groups. Logistic regression models were developed to predict pCR. Statistical tests included bootstrapping, z-test, chi-square, and Wilcoxon rank-sum.
resultsPatients with residual disease showed significantly higher kBPE in the normal-appearing parenchyma of the ipsilateral breast compared to the contralateral side. Parameters including enhancement rate α, A·α, area under the enhancement curve for 30 s AUC30, volume transfer constant K
conclusionsBilateral asymmetry of kBPE parameters derived from ultrafast DCE-MRI using KMC before NAC initiation can predict pCR with high accuracy, providing a new minimal-invasive biomarker for treatment response.
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