The role of magnetic resonance imaging in assessing residual disease and pathologic complete response in breast cancer patients receiving neoadjuvant chemotherapy: A systematic review

被引：177
作者：
Lobbes M.B.I. [1 ]
Prevos R. [1 ]
Smidt M. [2 ]
Tjan-Heijnen V.C.G. [3 ]
van Goethem M. [4 ]
Schipper R. [2 ]
Beets-Tan R.G. [1 ]
Wildberger J.E. [1 ]
机构：
[1] Department of Radiology, Maastricht University Medical Center, 6202 AZ Maastricht
[2] Department of Surgery, Maastricht University Medical Center, 6202 AZ Maastricht
[3] Medical Oncology, Maastricht University Medical Center, 6202AZ Maastricht
[4] Department of Radiology, University Hospital of Antwerp, 2650 Edegem
来源：
Insights into Imaging | 2013年 / 4卷 / 2期
关键词：
Breast cancer; MRI; Neoadjuvant chemotherapy; Residual disease;
D O I：
10.1007/s13244-013-0219-y
中图分类号：
学科分类号：
摘要：
Objectives: This systematic review aimed to assess the role of magnetic resonance imaging (MRI) in evaluating residual disease extent and the ability to detect pathologic complete response (pCR) after neoadjuvant chemotherapy for invasive breast cancer. Methods: PubMed, the Cochrane Library, MEDLINE, and Embase databases were searched for relevant studies published until 1 July 2012. After primary selection, two reviewers independently assessed the content of each eligible study using a standardised extraction form and pre-defined inclusion and exclusion criteria. Results: A total of 35 eligible studies were selected. Correlation coefficients of residual tumour size assessed by MRI and pathology were good, with a median value of 0. 698. Reported sensitivity, specificity, positive predictive value and negative predictive value for predicting pCR with MRI ranged from 25 to 100 %, 50-97 %, 47-73 % and 71-100 %, respectively. Both overestimation and underestimation were observed. MRI proved more accurate in determining residual disease than physical examination, mammography and ultrasound. Diagnostic accuracy of MRI after neoadjuvant chemotherapy could be influenced by treatment regimen and breast cancer subtype. Conclusions: Breast MRI accuracy for assessing residual disease after neoadjuvant chemotherapy is good and surpasses other diagnostic means. However, both overestimation and underestimation of residual disease extent could be observed. Main Messages: • Breast MRI accuracy for assessing residual disease is good and surpasses other diagnostic means.• Correlation coefficients of residual tumour size assessed by MRI and pathology were considered good.• However, both overestimation and underestimation of residual disease were observed.• Diagnostic accuracy of MRI seems to be affected by treatment regimen and breast cancer subtype. © 2013 The Author(s).
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页码：163 / 175
页数：12
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