Imaging biomarkers from multiparametric magnetic resonance imaging are associated with survival outcomes in patients with brain metastases from breast cancer
Objectives The aim of this study is to investigate the correlation of survival outcomes with imaging biomarkers from multiparametric magnetic resonance imaging (MRI) in patients with brain metastases from breast cancer (BMBC). Methods This study was approved by the institutional review board. Twenty...
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| Veröffentlicht in: | European radiology 2018-11, Vol.28 (11), p.4860-4870 |
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| creator | Chen, Bang-Bin Lu, Yen-Shen Yu, Chih-Wei Lin, Ching-Hung Chen, Tom Wei-Wu Wei, Shwu-Yuan Cheng, Ann-Lii Shih, Tiffany Ting-Fang |
| description | Objectives
The aim of this study is to investigate the correlation of survival outcomes with imaging biomarkers from multiparametric magnetic resonance imaging (MRI) in patients with brain metastases from breast cancer (BMBC).
Methods
This study was approved by the institutional review board. Twenty-two patients with BMBC who underwent treatment involving bevacizumab on day 1, etoposide on days 2-4, and cisplatin on day 2 in 21-day cycles were prospectively enrolled for a phase II study. Three brain MRIs were performed: before the treatment, on day 1, and on day 21. Eight imaging biomarkers were derived from dynamic contrast-enhanced MRI (Peak, IAUC
60
,
K
trans
,
k
ep
,
v
e
), diffusion-weighted imaging [apparent diffusion coefficient (ADC)], and MR spectroscopy (choline/N-acetylaspartate and choline/creatine ratios). The relative changes (Δ) in these biomarkers were correlated with the central nervous system (CNS)-specific progression-free survival (PFS) and overall survival (OS) using the Kaplan-Meier and Cox proportional hazard models.
Results
There were no significant differences in the survival outcomes as per the changes in the biomarkers on day 1. On day 21, those with a low Δ
K
trans
(
p
= 0.024) or ΔADC (
p
= 0.053) reduction had shorter CNS-specific PFS; further, those with a low ΔPeak (
p
= 0.012) or ΔIAUC
60
(
p
= 0.04) reduction had shorter OS compared with those with high reductions. In multivariate analyses, Δ
K
trans
and ΔPeak were independent prognostic factors for CNS-specific PFS and OS, respectively, after controlling for age, size, hormone receptors, and performance status.
Conclusions
Multiparametric MRI may help predict the survival outcomes in patients with BMBC.
Key Points
• Decreased angiogenesis after chemotherapy on day 21 indicated good survival outcome.
• ΔK
trans
was an independent prognostic factors for CNS-specific PFS.
• ΔPeak was an independent prognostic factors for OS.
• Multiparametric MRI helps clinicians to assess patients with BMBC.
• High-risk patients may benefit from more intensive follow-up or treatment strategies. |
| doi_str_mv | 10.1007/s00330-018-5448-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2040764487</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2040764487</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-2e83c17ad4fc47f38bd98956a19aa1a7f406ca22106e863ab18edd1f396685b3</originalsourceid><addsrcrecordid>eNp1kc2KFDEUhYMoTjv6AG4k4MZNaVJJV1JLGUYdGHAz-3ArdavNWJW0N6kRH8Z3NU21CoIQ8vudc8M9jL2U4q0UwrzLQiglGiFts9e6To_YTmrVNlJY_ZjtRK9sY_peX7BnOd8LIXqpzVN20fbGVMTu2M-bBQ4hHvgQ0gL0FSnzidLCl3Uu4QgECxYKnlcsYqkbwpwiRI88nKVAyCHn5AMUHPn3UL7wvNJDeICZp7X4tGDmIfIjlICx5A0ZCOpdtYdcB57rDoT1zP2pAj1nTyaYM744r5fs7sP13dWn5vbzx5ur97eNV6YtTYtWeWlg1JPXZlJ2GHvb7zuQPYAEM2nReWhbKTq0nYJBWhxHOam-6-x-UJfszWZ7pPRtxVzcErLHeYaIac2uFVqYrnbYVPT1P-h9WinWz1Wq-slOyxMlN8pTyplwckeq3aIfTgp3is5t0bkanTtF5_ZV8-rsvA4Ljn8Uv7OqQLsBuT7FA9Lf0v93_QXAfafi</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2039616417</pqid></control><display><type>article</type><title>Imaging biomarkers from multiparametric magnetic resonance imaging are associated with survival outcomes in patients with brain metastases from breast cancer</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Chen, Bang-Bin ; Lu, Yen-Shen ; Yu, Chih-Wei ; Lin, Ching-Hung ; Chen, Tom Wei-Wu ; Wei, Shwu-Yuan ; Cheng, Ann-Lii ; Shih, Tiffany Ting-Fang</creator><creatorcontrib>Chen, Bang-Bin ; Lu, Yen-Shen ; Yu, Chih-Wei ; Lin, Ching-Hung ; Chen, Tom Wei-Wu ; Wei, Shwu-Yuan ; Cheng, Ann-Lii ; Shih, Tiffany Ting-Fang</creatorcontrib><description>Objectives
The aim of this study is to investigate the correlation of survival outcomes with imaging biomarkers from multiparametric magnetic resonance imaging (MRI) in patients with brain metastases from breast cancer (BMBC).
Methods
This study was approved by the institutional review board. Twenty-two patients with BMBC who underwent treatment involving bevacizumab on day 1, etoposide on days 2-4, and cisplatin on day 2 in 21-day cycles were prospectively enrolled for a phase II study. Three brain MRIs were performed: before the treatment, on day 1, and on day 21. Eight imaging biomarkers were derived from dynamic contrast-enhanced MRI (Peak, IAUC
60
,
K
trans
,
k
ep
,
v
e
), diffusion-weighted imaging [apparent diffusion coefficient (ADC)], and MR spectroscopy (choline/N-acetylaspartate and choline/creatine ratios). The relative changes (Δ) in these biomarkers were correlated with the central nervous system (CNS)-specific progression-free survival (PFS) and overall survival (OS) using the Kaplan-Meier and Cox proportional hazard models.
Results
There were no significant differences in the survival outcomes as per the changes in the biomarkers on day 1. On day 21, those with a low Δ
K
trans
(
p
= 0.024) or ΔADC (
p
= 0.053) reduction had shorter CNS-specific PFS; further, those with a low ΔPeak (
p
= 0.012) or ΔIAUC
60
(
p
= 0.04) reduction had shorter OS compared with those with high reductions. In multivariate analyses, Δ
K
trans
and ΔPeak were independent prognostic factors for CNS-specific PFS and OS, respectively, after controlling for age, size, hormone receptors, and performance status.
Conclusions
Multiparametric MRI may help predict the survival outcomes in patients with BMBC.
Key Points
• Decreased angiogenesis after chemotherapy on day 21 indicated good survival outcome.
• ΔK
trans
was an independent prognostic factors for CNS-specific PFS.
• ΔPeak was an independent prognostic factors for OS.
• Multiparametric MRI helps clinicians to assess patients with BMBC.
• High-risk patients may benefit from more intensive follow-up or treatment strategies.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-018-5448-5</identifier><identifier>PMID: 29770848</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Angiogenesis ; Antineoplastic Agents - therapeutic use ; Aspartic Acid - analogs & derivatives ; Aspartic Acid - analysis ; Bevacizumab ; Biomarkers ; Biomarkers, Tumor - analysis ; Brain ; Brain cancer ; Brain Neoplasms - diagnostic imaging ; Brain Neoplasms - drug therapy ; Brain Neoplasms - mortality ; Brain Neoplasms - secondary ; Breast cancer ; Breast Neoplasms - pathology ; Cancer ; Central nervous system ; Chemotherapy ; Choline ; Choline - analysis ; Cisplatin ; Correlation analysis ; Creatine ; Creatinine - analysis ; Diagnostic Radiology ; Diffusion coefficient ; Etoposide ; Female ; Humans ; Imaging ; Internal Medicine ; Interventional Radiology ; Kaplan-Meier Estimate ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Magnetic Resonance Spectroscopy ; Medical imaging ; Medicine ; Medicine & Public Health ; Metastases ; Metastasis ; Middle Aged ; Monoclonal antibodies ; N-Acetylaspartate ; Neuroimaging ; Neuroradiology ; Oncology ; Patients ; Proportional Hazards Models ; Prospective Studies ; Radiology ; Receptors ; Reduction ; Resonance ; Risk groups ; Statistical models ; Survival ; Targeted cancer therapy ; Ultrasound</subject><ispartof>European radiology, 2018-11, Vol.28 (11), p.4860-4870</ispartof><rights>European Society of Radiology 2018</rights><rights>European Radiology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-2e83c17ad4fc47f38bd98956a19aa1a7f406ca22106e863ab18edd1f396685b3</citedby><cites>FETCH-LOGICAL-c372t-2e83c17ad4fc47f38bd98956a19aa1a7f406ca22106e863ab18edd1f396685b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-018-5448-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-018-5448-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29770848$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Bang-Bin</creatorcontrib><creatorcontrib>Lu, Yen-Shen</creatorcontrib><creatorcontrib>Yu, Chih-Wei</creatorcontrib><creatorcontrib>Lin, Ching-Hung</creatorcontrib><creatorcontrib>Chen, Tom Wei-Wu</creatorcontrib><creatorcontrib>Wei, Shwu-Yuan</creatorcontrib><creatorcontrib>Cheng, Ann-Lii</creatorcontrib><creatorcontrib>Shih, Tiffany Ting-Fang</creatorcontrib><title>Imaging biomarkers from multiparametric magnetic resonance imaging are associated with survival outcomes in patients with brain metastases from breast cancer</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objectives
The aim of this study is to investigate the correlation of survival outcomes with imaging biomarkers from multiparametric magnetic resonance imaging (MRI) in patients with brain metastases from breast cancer (BMBC).
Methods
This study was approved by the institutional review board. Twenty-two patients with BMBC who underwent treatment involving bevacizumab on day 1, etoposide on days 2-4, and cisplatin on day 2 in 21-day cycles were prospectively enrolled for a phase II study. Three brain MRIs were performed: before the treatment, on day 1, and on day 21. Eight imaging biomarkers were derived from dynamic contrast-enhanced MRI (Peak, IAUC
60
,
K
trans
,
k
ep
,
v
e
), diffusion-weighted imaging [apparent diffusion coefficient (ADC)], and MR spectroscopy (choline/N-acetylaspartate and choline/creatine ratios). The relative changes (Δ) in these biomarkers were correlated with the central nervous system (CNS)-specific progression-free survival (PFS) and overall survival (OS) using the Kaplan-Meier and Cox proportional hazard models.
Results
There were no significant differences in the survival outcomes as per the changes in the biomarkers on day 1. On day 21, those with a low Δ
K
trans
(
p
= 0.024) or ΔADC (
p
= 0.053) reduction had shorter CNS-specific PFS; further, those with a low ΔPeak (
p
= 0.012) or ΔIAUC
60
(
p
= 0.04) reduction had shorter OS compared with those with high reductions. In multivariate analyses, Δ
K
trans
and ΔPeak were independent prognostic factors for CNS-specific PFS and OS, respectively, after controlling for age, size, hormone receptors, and performance status.
Conclusions
Multiparametric MRI may help predict the survival outcomes in patients with BMBC.
Key Points
• Decreased angiogenesis after chemotherapy on day 21 indicated good survival outcome.
• ΔK
trans
was an independent prognostic factors for CNS-specific PFS.
• ΔPeak was an independent prognostic factors for OS.
• Multiparametric MRI helps clinicians to assess patients with BMBC.
• High-risk patients may benefit from more intensive follow-up or treatment strategies.</description><subject>Adult</subject><subject>Aged</subject><subject>Angiogenesis</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Aspartic Acid - analogs & derivatives</subject><subject>Aspartic Acid - analysis</subject><subject>Bevacizumab</subject><subject>Biomarkers</subject><subject>Biomarkers, Tumor - analysis</subject><subject>Brain</subject><subject>Brain cancer</subject><subject>Brain Neoplasms - diagnostic imaging</subject><subject>Brain Neoplasms - drug therapy</subject><subject>Brain Neoplasms - mortality</subject><subject>Brain Neoplasms - secondary</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - pathology</subject><subject>Cancer</subject><subject>Central nervous system</subject><subject>Chemotherapy</subject><subject>Choline</subject><subject>Choline - analysis</subject><subject>Cisplatin</subject><subject>Correlation analysis</subject><subject>Creatine</subject><subject>Creatinine - analysis</subject><subject>Diagnostic Radiology</subject><subject>Diffusion coefficient</subject><subject>Etoposide</subject><subject>Female</subject><subject>Humans</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Kaplan-Meier Estimate</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Magnetic Resonance Spectroscopy</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Monoclonal antibodies</subject><subject>N-Acetylaspartate</subject><subject>Neuroimaging</subject><subject>Neuroradiology</subject><subject>Oncology</subject><subject>Patients</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Radiology</subject><subject>Receptors</subject><subject>Reduction</subject><subject>Resonance</subject><subject>Risk groups</subject><subject>Statistical models</subject><subject>Survival</subject><subject>Targeted cancer therapy</subject><subject>Ultrasound</subject><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kc2KFDEUhYMoTjv6AG4k4MZNaVJJV1JLGUYdGHAz-3ArdavNWJW0N6kRH8Z3NU21CoIQ8vudc8M9jL2U4q0UwrzLQiglGiFts9e6To_YTmrVNlJY_ZjtRK9sY_peX7BnOd8LIXqpzVN20fbGVMTu2M-bBQ4hHvgQ0gL0FSnzidLCl3Uu4QgECxYKnlcsYqkbwpwiRI88nKVAyCHn5AMUHPn3UL7wvNJDeICZp7X4tGDmIfIjlICx5A0ZCOpdtYdcB57rDoT1zP2pAj1nTyaYM744r5fs7sP13dWn5vbzx5ur97eNV6YtTYtWeWlg1JPXZlJ2GHvb7zuQPYAEM2nReWhbKTq0nYJBWhxHOam-6-x-UJfszWZ7pPRtxVzcErLHeYaIac2uFVqYrnbYVPT1P-h9WinWz1Wq-slOyxMlN8pTyplwckeq3aIfTgp3is5t0bkanTtF5_ZV8-rsvA4Ljn8Uv7OqQLsBuT7FA9Lf0v93_QXAfafi</recordid><startdate>20181101</startdate><enddate>20181101</enddate><creator>Chen, Bang-Bin</creator><creator>Lu, Yen-Shen</creator><creator>Yu, Chih-Wei</creator><creator>Lin, Ching-Hung</creator><creator>Chen, Tom Wei-Wu</creator><creator>Wei, Shwu-Yuan</creator><creator>Cheng, Ann-Lii</creator><creator>Shih, Tiffany Ting-Fang</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20181101</creationdate><title>Imaging biomarkers from multiparametric magnetic resonance imaging are associated with survival outcomes in patients with brain metastases from breast cancer</title><author>Chen, Bang-Bin ; Lu, Yen-Shen ; Yu, Chih-Wei ; Lin, Ching-Hung ; Chen, Tom Wei-Wu ; Wei, Shwu-Yuan ; Cheng, Ann-Lii ; Shih, Tiffany Ting-Fang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-2e83c17ad4fc47f38bd98956a19aa1a7f406ca22106e863ab18edd1f396685b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Angiogenesis</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Aspartic Acid - analogs & derivatives</topic><topic>Aspartic Acid - analysis</topic><topic>Bevacizumab</topic><topic>Biomarkers</topic><topic>Biomarkers, Tumor - analysis</topic><topic>Brain</topic><topic>Brain cancer</topic><topic>Brain Neoplasms - diagnostic imaging</topic><topic>Brain Neoplasms - drug therapy</topic><topic>Brain Neoplasms - mortality</topic><topic>Brain Neoplasms - secondary</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - pathology</topic><topic>Cancer</topic><topic>Central nervous system</topic><topic>Chemotherapy</topic><topic>Choline</topic><topic>Choline - analysis</topic><topic>Cisplatin</topic><topic>Correlation analysis</topic><topic>Creatine</topic><topic>Creatinine - analysis</topic><topic>Diagnostic Radiology</topic><topic>Diffusion coefficient</topic><topic>Etoposide</topic><topic>Female</topic><topic>Humans</topic><topic>Imaging</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Kaplan-Meier Estimate</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Magnetic Resonance Spectroscopy</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Monoclonal antibodies</topic><topic>N-Acetylaspartate</topic><topic>Neuroimaging</topic><topic>Neuroradiology</topic><topic>Oncology</topic><topic>Patients</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Radiology</topic><topic>Receptors</topic><topic>Reduction</topic><topic>Resonance</topic><topic>Risk groups</topic><topic>Statistical models</topic><topic>Survival</topic><topic>Targeted cancer therapy</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Bang-Bin</creatorcontrib><creatorcontrib>Lu, Yen-Shen</creatorcontrib><creatorcontrib>Yu, Chih-Wei</creatorcontrib><creatorcontrib>Lin, Ching-Hung</creatorcontrib><creatorcontrib>Chen, Tom Wei-Wu</creatorcontrib><creatorcontrib>Wei, Shwu-Yuan</creatorcontrib><creatorcontrib>Cheng, Ann-Lii</creatorcontrib><creatorcontrib>Shih, Tiffany Ting-Fang</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection (ProQuest)</collection><collection>Natural Science Collection (ProQuest)</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Bang-Bin</au><au>Lu, Yen-Shen</au><au>Yu, Chih-Wei</au><au>Lin, Ching-Hung</au><au>Chen, Tom Wei-Wu</au><au>Wei, Shwu-Yuan</au><au>Cheng, Ann-Lii</au><au>Shih, Tiffany Ting-Fang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Imaging biomarkers from multiparametric magnetic resonance imaging are associated with survival outcomes in patients with brain metastases from breast cancer</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2018-11-01</date><risdate>2018</risdate><volume>28</volume><issue>11</issue><spage>4860</spage><epage>4870</epage><pages>4860-4870</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>Objectives
The aim of this study is to investigate the correlation of survival outcomes with imaging biomarkers from multiparametric magnetic resonance imaging (MRI) in patients with brain metastases from breast cancer (BMBC).
Methods
This study was approved by the institutional review board. Twenty-two patients with BMBC who underwent treatment involving bevacizumab on day 1, etoposide on days 2-4, and cisplatin on day 2 in 21-day cycles were prospectively enrolled for a phase II study. Three brain MRIs were performed: before the treatment, on day 1, and on day 21. Eight imaging biomarkers were derived from dynamic contrast-enhanced MRI (Peak, IAUC
60
,
K
trans
,
k
ep
,
v
e
), diffusion-weighted imaging [apparent diffusion coefficient (ADC)], and MR spectroscopy (choline/N-acetylaspartate and choline/creatine ratios). The relative changes (Δ) in these biomarkers were correlated with the central nervous system (CNS)-specific progression-free survival (PFS) and overall survival (OS) using the Kaplan-Meier and Cox proportional hazard models.
Results
There were no significant differences in the survival outcomes as per the changes in the biomarkers on day 1. On day 21, those with a low Δ
K
trans
(
p
= 0.024) or ΔADC (
p
= 0.053) reduction had shorter CNS-specific PFS; further, those with a low ΔPeak (
p
= 0.012) or ΔIAUC
60
(
p
= 0.04) reduction had shorter OS compared with those with high reductions. In multivariate analyses, Δ
K
trans
and ΔPeak were independent prognostic factors for CNS-specific PFS and OS, respectively, after controlling for age, size, hormone receptors, and performance status.
Conclusions
Multiparametric MRI may help predict the survival outcomes in patients with BMBC.
Key Points
• Decreased angiogenesis after chemotherapy on day 21 indicated good survival outcome.
• ΔK
trans
was an independent prognostic factors for CNS-specific PFS.
• ΔPeak was an independent prognostic factors for OS.
• Multiparametric MRI helps clinicians to assess patients with BMBC.
• High-risk patients may benefit from more intensive follow-up or treatment strategies.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>29770848</pmid><doi>10.1007/s00330-018-5448-5</doi><tpages>11</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0938-7994 |
| ispartof | European radiology, 2018-11, Vol.28 (11), p.4860-4870 |
| issn | 0938-7994 1432-1084 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2040764487 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Angiogenesis Antineoplastic Agents - therapeutic use Aspartic Acid - analogs & derivatives Aspartic Acid - analysis Bevacizumab Biomarkers Biomarkers, Tumor - analysis Brain Brain cancer Brain Neoplasms - diagnostic imaging Brain Neoplasms - drug therapy Brain Neoplasms - mortality Brain Neoplasms - secondary Breast cancer Breast Neoplasms - pathology Cancer Central nervous system Chemotherapy Choline Choline - analysis Cisplatin Correlation analysis Creatine Creatinine - analysis Diagnostic Radiology Diffusion coefficient Etoposide Female Humans Imaging Internal Medicine Interventional Radiology Kaplan-Meier Estimate Magnetic resonance imaging Magnetic Resonance Imaging - methods Magnetic Resonance Spectroscopy Medical imaging Medicine Medicine & Public Health Metastases Metastasis Middle Aged Monoclonal antibodies N-Acetylaspartate Neuroimaging Neuroradiology Oncology Patients Proportional Hazards Models Prospective Studies Radiology Receptors Reduction Resonance Risk groups Statistical models Survival Targeted cancer therapy Ultrasound |
| title | Imaging biomarkers from multiparametric magnetic resonance imaging are associated with survival outcomes in patients with brain metastases from breast cancer |
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