Tumor texture parameters of invasive ductal breast carcinoma in neoadjuvant chemotherapy: early identification of non-responders on breast MRI.

Purpose. Texture analysis (TA) parameters (variance of SI, mean of gradient, variance of gradient, kurtosis of SI, and entropy) in patients with invasive ductal carcinoma (IDC) contribute to objective assessment of neoadjuvant chemotherapy (NACT) activity. The objective was to assess TA parameters in early identification of non-responders (NR) in NACT, after the 2nd cycle of NACT.

Material and methods. Fifty patients (N = 50) were included in the retrospective analysis of baseline and MRI following the 2nd cycle of NACT. TA parameters were computed and correlated to the lesion size and DWI-ADC in NR (N1 = 25). Additional matched responders (R, N2 = 25) assessed for the same parameters, served as the control group. Results: Tumor size and ADC did not change significantly in NR after the 2nd cycle of NACT (2.88 ± 0.38 vs. 2.76 ± 0.36 [cm], p = 0.131; 1.01 ± 0.14 vs. 1.05 ± 0.13 [mm²/s × 10⁻³], p = 0.363), but TA parameters changed significantly: variance of gradient (346.5 ± 12.6 vs. 355.6 ± 16.9, p = 0.01), kurtosis of SI (1.47 ± 0.09 vs. 1.54 ± 0.11, p = 0.02), entropy LH (60.39 ± 4.34 vs. 64.42 ± 3.05, p = 0.001) and entropy HL (61.02 ± 5.51 vs. 65.63 ± 3.63, p < 0.00001). TA parameters, particularly entropy (EN LH 64.42 ± 3.05 vs. 61.59 ± 1.76, p < 0.0001; EN HL 65.63 ± 3.63 vs. 62.89 ± 2.05, p < 0.0001), significantly differ between NR and R in early response assessment. Conclusion: Entropy, kurtosis of SI and variance of gradient tend to increase in NR. TA parameters significantly differ between NR and R after the 2nd cycle of NACT. TA parameters, related to morpho-functional parameters may contribute to early NR identification.