The value of multi-parameter magnetic resonance imaging based on IVIM in predicting the efficacy of neoadjuvant che-motherapy for breast cancer

WANG Yiwen; WANG Zhengtong; WANG Weiwei; SUN Zhanguo

doi:10.20258/j.cnki.1006-9011.2025.05.016

Abstract：Objective The objective of this study is to investigate the value of multi-parameter magnetic resonance imaging(MRI)based on the intravoxel incoherent motion(IVIM)in predicting the effectiveness of neoadjuvant chemotherapy(NAC)for breast cancer.Methods Ninety-seven breast cancer patients,whose diagnosis was validated by puncture pathology,were col-lected after receiving NAC followed by surgical intervention.The patients were allocated at random to either a training dataset or a validation dataset,with a proportional distribution of 70%to the training set and 30%to the validation set.According to the Miller&Payne pathological response grading standard,the patients in the two data sets were divided into pCR group and N-pCR group.The MRI features,parameters and clinicopathological features of the patients were collected,and the combined predic-tion model of NAC efficacy in breast cancer was constructed based on the results of multivariate analysis.Results Among the 97 patients,30 achieved pCR(21 in the training set and 9 in the test set),while 67 were classified as N-pCR(46 in the training set and 21 in the test set).In the training set,both ADC and D values were significantly lower in the pCR group com-pared to the N-pCR group(both P<0.001).Additionally,patients in the pCR group were more likely to have negative PR expres-sion(P<0.001),positive HER-2 expression(P=0.001),and high Ki-67 expression(P=0.013).Logistic regression analysis iden-tified D(OR=0.012,P=0.049),PR(OR=28.137,P=0.020),HER-2(OR=0.045,P=0.005),and Ki-67(OR=0.082,P=0.046)as independent predictive factors for the efficacy of NAC in breast cancer.The predictive model demonstrated AUC values of 0.935(95%CI:0.877-0.993)in the training set and 0.894(95%CI:0.767-1.000)in the test set.Conclusion Multi-parameter magnetic resonance imaging based on IVIM can predict the efficacy of NAC in breast cancer before treatment,and pro-vide a useful reference for clinical prognosis evaluation.