Magnetic resonance imaging and ultrasound for prediction of residual tumor size in early breast cancer within the ADAPT subtrials

Monika Graeser*, Simone Schrading, Oleg Gluz, Kevin Strobel, Christopher Herzog, Lale Umutlu, Alex Frydrychowicz, Dorothea Rjosk-Dendorfer, Rachel Würstlein, Ralph Culemann, Christine Eulenburg, Jascha Adams, Henrik Nitzsche, Anna Prange, Sherko Kümmel, Eva Maria Grischke, Helmut Forstbauer, Michael Braun, Jochem Potenberg, Raquel von SchumannBahriye Aktas, Cornelia Kolberg-Liedtke, Nadia Harbeck, Christiane K. Kuhl, Ulrike Nitz

*Corresponding author for this work

    Abstract

    Background: Prediction of histological tumor size by post-neoadjuvant therapy (NAT) ultrasound and magnetic resonance imaging (MRI) was evaluated in different breast cancer subtypes. Methods: Imaging was performed after 12-week NAT in patients enrolled into three neoadjuvant WSG ADAPT subtrials. Imaging performance was analyzed for prediction of residual tumor measuring ≤10 mm and summarized using positive (PPV) and negative (NPV) predictive values. Results: A total of 248 and 588 patients had MRI and ultrasound, respectively. Tumor size was over- or underestimated by < 10 mm in 4.4% and 21.8% of patients by MRI and in 10.2% and 15.8% by ultrasound. Overall, NPV (proportion of correctly predicted tumor size ≤10 mm) of MRI and ultrasound was 0.92 and 0.83; PPV (correctly predicted tumor size > 10 mm) was 0.52 and 0.61. MRI demonstrated a higher NPV and lower PPV than ultrasound in hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-positive and in HR−/HER2+ tumors. Both methods had a comparable NPV and PPV in HR−/HER2− tumors. Conclusions: In HR+/HER2+ and HR−/HER2+ breast cancer, MRI is less likely than ultrasound to underestimate while ultrasound is associated with a lower risk to overestimate tumor size. These findings may help to select the most optimal imaging approach for planning surgery after NAT. Trial registration: Clinicaltrials.gov, NCT01815242 (registered on March 21, 2013), NCT01817452 (registered on March 25, 2013), and NCT01779206 (registered on January 30, 2013).

    Original languageEnglish
    Article number36
    JournalBreast Cancer Research
    Volume23
    Issue number1
    Pages (from-to)36
    ISSN1465-5411
    DOIs
    Publication statusPublished - 18.03.2021

    Research Areas and Centers

    • Academic Focus: Biomedical Engineering

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