Korean J Radiol.  2013 Feb;14(1):13-20. 10.3348/kjr.2013.14.1.13.

Comparison of the Diagnostic Performance of Response Evaluation Criteria in Solid Tumor 1.0 with Response Evaluation Criteria in Solid Tumor 1.1 on MRI in Advanced Breast Cancer Response Evaluation to Neoadjuvant Chemotherapy

• Jeh SK
• Kim SH
• Kang BJ

• KMID: 1430039
• DOI: http://doi.org/10.3348/kjr.2013.14.1.13

Abstract

OBJECTIVE
To compare the diagnostic performance in evaluating the response of neoadjuvant chemotherapy (NAC), between the response evaluation criteria in solid tumor (RECIST) 1.0 and RECIST 1.1, on magnetic resonance imaging (MRI) for advance breast cancer patients.
MATERIALS AND METHODS
Breast cancer patients, who underwent NAC between 2005 and 2010, were included. Both prechemotherapy and post-chemotherapy MRIs were performed within 1-4 weeks before and after NAC. Only the patients with subsequent surgery were included. The response to NAC was assessed by using RECIST 1.0 and RECIST 1.1. Patients with a complete or partial response on MRI were considered as responders, and those with stable or progressive disease were considered as non-responders. Tumor necrosis > 50% on pathology was defined as responders and necrosis < 50% was defined as non-responders. The diagnostic accuracy of both RECIST 1.0 and RECIST 1.1 was analyzed and compared by receiver operating characteristic curve analysis.
RESULTS
Seventy-nine females (mean age 51.0 +/- 9.3 years) were included. Pathology showed 45 responders and 34 non-responders. There were 49 responders and 30 non-responders on RECIST 1.0, and in 55 patients, RECIST 1.0 results agreed with pathologic results (69.6%). RECIST 1.1 showed 52 responders and 27 non-responders. In 60 patients, RECIST 1.1 results were in accordance with pathology results (75.9%). The area under the ROC curve was 0.809 for RECIST 1.0 and 0.853 for RECIST 1.1.
CONCLUSION
RECIST 1.1 showed better diagnostic performance than RECIST 1.0, although there was no statistically significant difference between the two.

Keyword

Breast neoplasm; Chemotherapy; Magnetic resonance imaging; Response evaluation criteria in solid tumor

MeSH Terms

Breast Neoplasms/*drug therapy/*pathology/surgery
Chemotherapy, Adjuvant
Contrast Media/diagnostic use
Female
Gadolinium DTPA/diagnostic use
Humans
Magnetic Resonance Imaging/*methods
Middle Aged
Neoadjuvant Therapy
Predictive Value of Tests
ROC Curve
Sensitivity and Specificity
Statistics, Nonparametric
Survival Analysis
Treatment Outcome

Figure

• 

  Fig. 1 44-year-old woman with invasive ductal carcinoma in left breast underwent neoadjuvant chemotherapy (ET-epirubicin-doxetaxel combination therapy) four times.Small main mass and large axillary lymph node metastasis were present on both pre-chemotherapy (A, B) and post-chemotherapy (C, D) maximal intensity projection (MIP) MR images. On RECIST 1.0, this case was classified into non-responder group. In contrast, this case was analyzed into the responder group on RECIST 1.1. This case turned out to be the responder in pathologic evaluation. RECIST = Response Evaluation Criteria in Solid Tumor

• 

  Fig. 2 50-year-old woman with invasive ductal carcinoma in right breast underwent four times neoadjuvant chemotherapy (AT-Doxorubicin [adriamycin]-taxotere [Docetaxel] combination therapy).Huge main mass and metastatic axillary lymph node were present on both pre-chemotherapy (A) and post-chemotherapy (B) maximal intensity projection (MIP) MR images. Both RECIST 1.0 and RECITST 1.1 classified this patient into responder group. In addition, this case was confirmed as responder in pathologic evaluation. RECIST = Response Evaluation Criteria in Solid Tumor

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