Biomechanical parameters quantified by MR elastography for predicting response to neoadjuvant chemotherapy and disease-free survival in breast cancer: a prospective longitudinal study
Abstract Background Little is known regarding biomechanical properties derived from multifrequency MR elastography temporal changes during neoadjuvant chemotherapy (NAC) and associated with pathologic complete response (pCR) and disease-free survival (DFS) in breast cancer. We aimed to investigate t...
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2025-05-01
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| Series: | Breast Cancer Research |
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| Online Access: | https://doi.org/10.1186/s13058-025-02035-4 |
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| author | Xiaoxia Wang Yao Huang Jinfang Shi Ying Cao Huifang Chen Lan Li Lu Wang Sun Tang Xueqin Gong Haiping Huang Ting Yin Jiuquan Zhang |
| author_facet | Xiaoxia Wang Yao Huang Jinfang Shi Ying Cao Huifang Chen Lan Li Lu Wang Sun Tang Xueqin Gong Haiping Huang Ting Yin Jiuquan Zhang |
| author_sort | Xiaoxia Wang |
| collection | DOAJ |
| description | Abstract Background Little is known regarding biomechanical properties derived from multifrequency MR elastography temporal changes during neoadjuvant chemotherapy (NAC) and associated with pathologic complete response (pCR) and disease-free survival (DFS) in breast cancer. We aimed to investigate temporal changes in NAC-associated biomechanical parameters and assess biomechanical parameters as a predictor of pCR and DFS in breast cancer. Methods In this prospective longitudinal study, participants with breast cancer who received NAC were enrolled from February 2021 to May 2023. All participants underwent multifrequency MR-elastography at four timepoints: before NAC (T1) and after 2 (T2), 4 (T3), and 6 (T4) cycles. Tomoelastography postprocessing provided biomechanical maps of shear-wave-speed (c) and loss-angle (φ) as proxies of stiffness and viscosity. The biomechanical parameters were validated by means of correlation with histopathologic measurements. Generalized estimating equations were used to compare temporal changes in biomechanical parameters at four time points. Logistic regression was used for pCR analysis and Cox proportional hazards regression was used for survival analysis. Predictive performance was assessed with area under the receiver operating characteristic curve (AUC) analysis. Results A total of 235 women (50.6 ± 7.9 years) with 964 scans were enrolled. Biomechanical parameters were supported by positive correlations with pathologic examination–based stroma fraction (c: r =.76, P <.001; φ: r =.49, P =.008) and cellularity (c: r =.58, P =.001; φ: r =.40, P =.035). Progesterone receptor, human epidermal growth factor receptor-2 (HER2), T2-c, and T2-φ were independently associated with pCR (all P <.05). Estrogen receptor, HER2, clinical stage, and change in φ at the early stage of NAC were associated with PFS (all P <.05). The predictive model, which incorporated biomechanical parameters and clinicopathologic characteristics significantly outperformed the clinicopathologic model in predicting pCR (AUC: 0.95, 95% confidence interval [CI]: 0.92, 0.98 vs. 0.79, 95%CI: 0.73, 0.84; P <.001). The predictive model also showed good discrimination ability for DFS (C-index = 0.82, 95%CI: 0.72, 0.90) and stratified prognosis into low-risk and high-risk groups (log-rank, P <.001). Conclusions During NAC, patients with higher tumor stiffness and viscosity are less likely to achieve DFS and pCR. The biomechanical parameters exhibit excellent biological interpretability and serve as valuable biomarkers for predicting pCR and DFS in patients with breast cancer. |
| format | Article |
| id | doaj-art-7ab60ab2eb00449f8c506d31f51a2f55 |
| institution | Kabale University |
| issn | 1465-542X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | Breast Cancer Research |
| spelling | doaj-art-7ab60ab2eb00449f8c506d31f51a2f552025-08-20T03:53:16ZengBMCBreast Cancer Research1465-542X2025-05-0127111510.1186/s13058-025-02035-4Biomechanical parameters quantified by MR elastography for predicting response to neoadjuvant chemotherapy and disease-free survival in breast cancer: a prospective longitudinal studyXiaoxia Wang0Yao Huang1Jinfang Shi2Ying Cao3Huifang Chen4Lan Li5Lu Wang6Sun Tang7Xueqin Gong8Haiping Huang9Ting Yin10Jiuquan Zhang11Department of Radiology, Chongqing University Cancer HospitalDepartment of Radiology, Chongqing University Cancer HospitalDepartment of Radiology, Chongqing University Cancer HospitalDepartment of Radiology, Chongqing University Cancer HospitalDepartment of Radiology, Chongqing University Cancer HospitalDepartment of Radiology, Chongqing University Cancer HospitalDepartment of Radiology, Chongqing University Cancer HospitalDepartment of Radiology, Chongqing University Cancer HospitalDepartment of Radiology, Chongqing University Cancer HospitalDepartment of Pathology, Chongqing Key Laboratory for Intelligent Oncology in Breast Cancer (iCQBC), Chongqing University Cancer HospitalMR Collaborations, Siemens Healthineers LtdDepartment of Radiology, Chongqing University Cancer HospitalAbstract Background Little is known regarding biomechanical properties derived from multifrequency MR elastography temporal changes during neoadjuvant chemotherapy (NAC) and associated with pathologic complete response (pCR) and disease-free survival (DFS) in breast cancer. We aimed to investigate temporal changes in NAC-associated biomechanical parameters and assess biomechanical parameters as a predictor of pCR and DFS in breast cancer. Methods In this prospective longitudinal study, participants with breast cancer who received NAC were enrolled from February 2021 to May 2023. All participants underwent multifrequency MR-elastography at four timepoints: before NAC (T1) and after 2 (T2), 4 (T3), and 6 (T4) cycles. Tomoelastography postprocessing provided biomechanical maps of shear-wave-speed (c) and loss-angle (φ) as proxies of stiffness and viscosity. The biomechanical parameters were validated by means of correlation with histopathologic measurements. Generalized estimating equations were used to compare temporal changes in biomechanical parameters at four time points. Logistic regression was used for pCR analysis and Cox proportional hazards regression was used for survival analysis. Predictive performance was assessed with area under the receiver operating characteristic curve (AUC) analysis. Results A total of 235 women (50.6 ± 7.9 years) with 964 scans were enrolled. Biomechanical parameters were supported by positive correlations with pathologic examination–based stroma fraction (c: r =.76, P <.001; φ: r =.49, P =.008) and cellularity (c: r =.58, P =.001; φ: r =.40, P =.035). Progesterone receptor, human epidermal growth factor receptor-2 (HER2), T2-c, and T2-φ were independently associated with pCR (all P <.05). Estrogen receptor, HER2, clinical stage, and change in φ at the early stage of NAC were associated with PFS (all P <.05). The predictive model, which incorporated biomechanical parameters and clinicopathologic characteristics significantly outperformed the clinicopathologic model in predicting pCR (AUC: 0.95, 95% confidence interval [CI]: 0.92, 0.98 vs. 0.79, 95%CI: 0.73, 0.84; P <.001). The predictive model also showed good discrimination ability for DFS (C-index = 0.82, 95%CI: 0.72, 0.90) and stratified prognosis into low-risk and high-risk groups (log-rank, P <.001). Conclusions During NAC, patients with higher tumor stiffness and viscosity are less likely to achieve DFS and pCR. The biomechanical parameters exhibit excellent biological interpretability and serve as valuable biomarkers for predicting pCR and DFS in patients with breast cancer.https://doi.org/10.1186/s13058-025-02035-4Breast neoplasmsNeoadjuvant therapyElasticity imaging techniquesMagnetic resonance imaging |
| spellingShingle | Xiaoxia Wang Yao Huang Jinfang Shi Ying Cao Huifang Chen Lan Li Lu Wang Sun Tang Xueqin Gong Haiping Huang Ting Yin Jiuquan Zhang Biomechanical parameters quantified by MR elastography for predicting response to neoadjuvant chemotherapy and disease-free survival in breast cancer: a prospective longitudinal study Breast Cancer Research Breast neoplasms Neoadjuvant therapy Elasticity imaging techniques Magnetic resonance imaging |
| title | Biomechanical parameters quantified by MR elastography for predicting response to neoadjuvant chemotherapy and disease-free survival in breast cancer: a prospective longitudinal study |
| title_full | Biomechanical parameters quantified by MR elastography for predicting response to neoadjuvant chemotherapy and disease-free survival in breast cancer: a prospective longitudinal study |
| title_fullStr | Biomechanical parameters quantified by MR elastography for predicting response to neoadjuvant chemotherapy and disease-free survival in breast cancer: a prospective longitudinal study |
| title_full_unstemmed | Biomechanical parameters quantified by MR elastography for predicting response to neoadjuvant chemotherapy and disease-free survival in breast cancer: a prospective longitudinal study |
| title_short | Biomechanical parameters quantified by MR elastography for predicting response to neoadjuvant chemotherapy and disease-free survival in breast cancer: a prospective longitudinal study |
| title_sort | biomechanical parameters quantified by mr elastography for predicting response to neoadjuvant chemotherapy and disease free survival in breast cancer a prospective longitudinal study |
| topic | Breast neoplasms Neoadjuvant therapy Elasticity imaging techniques Magnetic resonance imaging |
| url | https://doi.org/10.1186/s13058-025-02035-4 |
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