Changes in kinetic heterogeneity of breast cancer via computer-aided diagnosis on MRI predict the pathological response to neoadjuvant systemic therapy

To evaluate whether the computer-aided diagnosis (CAD)–extracted kinetic heterogeneity of breast cancer on MRI and changes therein during treatment were associated with the pathological response to neoadjuvant systemic therapy (NST). Consecutive patients with invasive breast cancer, who underwent NST followed by surgery between 2014 and 2020, were retrospectively evaluated. Using a commercial CAD system, kinetic features (angiovolume, peak enhancement, delayed enhancement profiles, and kinetic heterogeneity) of breast cancer were assessed with pre- and mid-treatment MRI. Multivariate logistic regression was used to identify the associations between CAD-extracted kinetic features and pathological complete response (pCR). A total of 130 patients (mean age, 55 years) were included, 37 (28.5