{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:38:35Z","timestamp":1761007115935,"version":"build-2065373602"},"reference-count":42,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T00:00:00Z","timestamp":1718582400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["analyticalsciencejournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["NMR in Biomedicine"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:p>Early tumor response prediction can help avoid overtreatment with unnecessary chemotherapy sessions. It is important to determine whether multiple apparent diffusion coefficient indices (<jats:italic>S<\/jats:italic> index, ADC\u2010diff) are effective in the early prediction of pathological response to neoadjuvant chemotherapy (NAC) in breast cancer (BC). Patients with stage II and III BCs who underwent <jats:italic>T<\/jats:italic><jats:sub>1<\/jats:sub>WI, diffusion\u2010weighted imaging (DWI), and dynamic contrast\u2010enhanced MRI using a 3\u2009T system were included. They were divided into two groups: major histological responders (MHRs, Miller\u2013Payne G4\/5) and nonmajor histological responders (nMHRs, Miller\u2013Payne G1\u20133). Three <jats:italic>b<\/jats:italic> values were used for DWI to derive the <jats:italic>S<\/jats:italic> index; ADC\u2010diff values were obtained using <jats:italic>b<\/jats:italic>\u2009=\u20090 and 1000\u2009s\/mm<jats:sup>2<\/jats:sup>. The different interquartile ranges of percentile <jats:italic>S<\/jats:italic>\u2010index and ADC\u2010diff values after treatment were calculated and compared. The assessment was performed at baseline and after two and four NAC cycles. A total of 59 patients were evaluated. There are some correlations of interquartile ranges of <jats:italic>S<\/jats:italic>\u2010index parameters and ADC\u2010diff values with histopathological prognostic factors (such as estrogen receptor and human epidermal growth factor receptor 2 expression, all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), but no significant differences were found in some other interquartile ranges of <jats:italic>S<\/jats:italic>\u2010index parameters or ADC\u2010diff values between progesterone receptor positive and negative or for Ki\u201067 tumors (all <jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). No differences were found in the dynamic contrast\u2010enhanced MRI characteristics between the two groups. HER\u20102 expression and kurtosis of the <jats:italic>S<\/jats:italic>\u2010index distribution were screened out as independent risk factors for predicting MHR group (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05, area under the curve (AUC)\u2009=\u20090.811) before NAC. After early NAC (two cycles), only the 10th percentile <jats:italic>S<\/jats:italic> index was statistically significant between the two groups (<jats:italic>p<\/jats:italic> &lt;\u20090.05, AUC\u2009=\u20090.714). No significant differences were found in ADC\u2010diff value at any time point of NAC between the two groups (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.1). These findings demonstrate that the <jats:italic>S<\/jats:italic>\u2010index value may be used as an early predictor of pathological response to NAC in BC; the value of ADC\u2010diff as an imaging biomarker of NAC needs to be further confirmed by ongoing multicenter prospective trials.<\/jats:p>","DOI":"10.1002\/nbm.5176","type":"journal-article","created":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T05:56:19Z","timestamp":1718603779000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The contrast\u2010free diffusion MRI multiple index for the early prediction of pathological response to neoadjuvant chemotherapy in breast cancer"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2242-9249","authenticated-orcid":false,"given":"Lina","family":"Zhang","sequence":"first","affiliation":[{"name":"PET\u2010CT Center The First Affiliated Hospital of Xi'an Jiaotong University  Xi'an 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