Functional Tumor Volume by Fast Dynamic Contrast‐Enhanced MRI for Predicting Neoadjuvant Systemic Therapy Response in Triple‐Negative Breast Cancer. Issue 1 (15th February 2021)

• Record Type: Journal Article
• Authors: Musall, Benjamin C.; Abdelhafez, Abeer H.; Adrada, Beatriz E.; Candelaria, Rosalind P.; Mohamed, Rania M.M.; Boge, Medine; Le‐Petross, Huong; Arribas, Elsa; Lane, Deanna L.; Spak, David A.; Leung, Jessica W.T.; Hwang, Ken‐Pin; Son, Jong Bum; Elshafeey, Nabil A.; Mahmoud, Hagar S.; Wei, Peng; Sun, Jia; Zhang, Shu; White, Jason B.; Ravenberg, Elizabeth E.; Litton, Jennifer K.; Damodaran, Senthil; Thompson, Alastair M.; Moulder, Stacy L.; Yang, Wei T.; Pagel, Mark D.; Rauch, Gaiane M.; Ma, Jingfei
• Is Part Of: Journal of magnetic resonance imaging. Volume 54:Issue 1(2021)
• Page Start: 251
• Page End: 260
• Publication Date: 2021-02-15
• Subjects: Triple‐negative breast cancer -- DCE MRI -- functional tumor volume -- breast MRI -- treatment response; Magnetic resonance imaging -- Periodicals; 616
• DOI: 10.1002/jmri.27557
• Languages: English
• ISSNs: 1053-1807

Abstract

Abstract : Background: Dynamic contrast‐enhanced (DCE) MRI is useful for diagnosis and assessment of treatment response in breast cancer. Fast DCE MRI offers a higher sampling rate of contrast enhancement curves in comparison to conventional DCE MRI, potentially characterizing tumor perfusion kinetics more accurately for measurement of functional tumor volume (FTV) as a predictor of treatment response. Purpose: To investigate FTV by fast DCE MRI as a predictor of neoadjuvant systemic therapy (NAST) response in triple‐negative breast cancer (TNBC). Study Type: Prospective. Population/Subjects: Sixty patients with biopsy‐confirmed TNBC between December 2016 and September 2020. Field Strength/Sequence: A 3.0 T/3D fast spoiled gradient echo‐based DCE MRI Assessment: Patients underwent MRI at baseline and after four cycles (C4) of NAST, followed by definitive surgery. DCE subtraction images were analyzed in consensus by two breast radiologists with 5 (A.H.A.) and 2 (H.S.M.) years of experience. Tumor volumes (TV) were measured on early and late subtractions. Tumors were segmented on 1 and 2.5‐minute early phases subtractions and FTV was determined using optimized signal enhancement thresholds. Interpolated enhancement curves from segmented voxels were used to determine optimal early phase timing. Statistical Tests: Tumor volumes were compared between patients who had a pathologic complete response (pCR) and those who did not using the area under the receiver operating curve (AUC) and Mann–Whitney U test. Results: About 26 of 60 patients (43%) had pCR. FTV at 1 minute after injection at C4 provided the best discrimination between pCR and non‐pCR, with AUC (95% confidence interval [CI]) = 0.85 (0.74, 0.95) ( P < 0.05). The 1‐minute timing was optimal for FTV measurements at C4 and for the change between C4 and baseline. TV from the early phase at C4 also yielded a good AUC (95%CI) of 0.82 (0.71, 0.93) ( P < 0.05). Data Conclusion: FTV and TV measured at 1 minute after injection can predict response to NAST in TNBC. Level of Evidence: 1 Technical Efficacy: 4