Functional Tumor Volume by Fast Dynamic Contrast-Enhanced MRI for Predicting Neoadjuvant Systemic Therapy Response in...

Area of Science:

• Oncology
• Radiology
• Medical Imaging

Background:

• Dynamic contrast-enhanced (DCE) MRI is crucial for diagnosing breast cancer and assessing treatment response.
• Fast DCE MRI enhances contrast curve sampling for more accurate tumor perfusion kinetics and functional tumor volume (FTV) measurement.
• FTV serves as a potential predictor of treatment response.

Purpose of the Study:

• To evaluate functional tumor volume (FTV) derived from fast DCE MRI as a predictor of treatment response to neoadjuvant systemic therapy (NAST) in triple-negative breast cancer (TNBC).

Main Methods:

• A prospective study included 60 patients with biopsy-confirmed TNBC undergoing fast 3.0T/3D spoiled gradient echo-based DCE MRI at baseline and after four cycles of NAST.
• Tumor volumes (TV) and FTV were measured using early phase (1 and 2.5 minutes) DCE subtraction images with optimized signal enhancement thresholds.
• Statistical analysis, including receiver operating curve (AUC) and Mann-Whitney U test, compared tumor volumes between patients achieving pathologic complete response (pCR) and those who did not.

Main Results:

• 43% (26/60) of patients achieved pCR.
• FTV measured at 1 minute post-injection after four NAST cycles (C4) showed the highest discrimination between pCR and non-pCR (AUC = 0.85).
• The 1-minute timing was optimal for FTV measurements at C4 and for the change from baseline, with early phase TV at C4 also showing good predictive value (AUC = 0.82).

Conclusions:

• Functional tumor volume (FTV) and tumor volume (TV) measured at 1 minute post-injection are effective predictors of NAST response in TNBC.
• Fast DCE MRI, particularly FTV at 1 minute, can aid in assessing treatment efficacy in TNBC patients undergoing neoadjuvant therapy.