Enhancement of breast cancer on pre-treatment dynamic contrast-enhanced MRI using computer-aided detection is associated with response to neo-adjuvant chemotherapy

Summary Purpose To evaluate whether enhancement of breast cancer on pre-treatment dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) as evaluated semi-quantitatively using computer-aided detection (CAD) is associated with response to neo-adjuvant chemotherapy. Materials and methods A total of 84 women, (mean age, 51 ± 10 [SD] years; range: 30–73 years) with 84 breast cancers who underwent MRI before neo-adjuvant chemotherapy were included in this retrospective study. The proportion of each type of signal intensity-time curve (SITC) (type 1: persistent; type 2: plateau; Type 3: washout) within the tumor volume was quantified semi-automatically using a CAD system (Aegis ® , Sentinelle medical, Toronto, Canada) and was compared to histological features of the tumors and to pathological response to neo-adjuvant chemotherapy. Results Pathological complete response was obtained in 29 patients (35%). Proportion of SITC type 1 was greater in non-responders ( P  = 0.019) while proportion of SITC type 3 was greater in responders ( P  = 0.04). Sensitivity, specificity, and accuracy of proportion of SITC type 1 for the identification of incomplete response on pathology were 42% (95% CI: 29%–56%), 90% (95% CI: 73%–98%), and 59% (95% CI: 48%–70%), respectively. Conclusion Proportion of SITC type 1 (persistent) in breast cancers on pre-treatment MRI as semi-automatically quantified using a CAD system is associated with absence of pathological complete response to neo-adjuvant chemotherapy with good specificity.