Related Experiment Video
Updated: Oct 23, 2025

Tracking the Mammary Architectural Features and Detecting Breast Cancer with Magnetic Resonance Diffusion Tensor Imaging
Published on: December 15, 2014
Breast MRI during Neoadjuvant Chemotherapy: Lack of Background Parenchymal Enhancement Suppression and Inferior
Natsuko Onishi1, Wen Li1, David C Newitt1
1Author affiliations: From the Department of Radiology & Biomedical Imaging, University of California San Francisco, 1600 Divisadero St, Room C255, San Francisco, CA 94115 (N.O., W.L., D.C.N., R.J.H., F.S., A.A.T.N., V.A.A., J.G., E.F.J., L.J.W., B.N.J., E.R.P., N.M.H.); Department of Breast Radiology, Karolinska University Hospital, Solna, Stockholm, Sweden (F.S.); Department of Radiology, Kaiser Permanente Vallejo Medical Center, Vallejo, Calif (V.A.A.); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, Calif (J.K.); Department of Radiology, University of California San Diego, La Jolla, Calif (H.O.F., M.E.); Department of Radiology, The University of Alabama at Birmingham, Birmingham, Ala (K.W.Z., S.W., H.R.U.); Department of Radiology, University of Minnesota, Minneapolis, Minn (M.T.N., A.L.C., P.J.B.); Department of Radiology, Loyola Medicine, Maywood, Ill (T.K., K.W., K.M.); Department of Radiology, University of Colorado Denver, Denver, Colo (D.W., K.F., D.L.P., L.H.); Department of Diagnostic Radiology, Mayo Clinic Rochester, Rochester, Minn (K.R.B.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (E.S.M., M.R., D.K.); Department of Radiology, University of Chicago Medical Center, Chicago, Ill (H.A., D.S.); Department of Radiology, Georgetown University, Washington, DC (E.C., C.D.); Department of Radiology, University of Southern California, Los Angeles, Calif (P.S., L.H.L.); Department of Radiology, Swedish Cancer Institute, Seattle, Wash (D.H.B., B.P.); Department of Radiology, Oregon Health & Science University, Portland, Ore (K.Y.O., N.J., L.A.T.); Department of Radiology, Moffitt Cancer Center, Tampa, Fla (B.N., J.D.); Department of Women's Imaging, St. Joseph's Women's Hospital, Tampa, Fla (J.D.); Department of Radiology, Emory University, Atlanta, Ga (M.S.N.); Department of Radiology, Mayo Clinic Arizona, Phoenix, Ariz (M.E.G.); Department of Radiology, Inova Health System, Fairfax, Va (E.B.); Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, Mass (C.D.L.); Department of Radiology, University of Washington, Seattle, Wash (S.C.P.); Department of Medical Imaging, Banner University Medical Center Tucson, Tucson, Ariz (K.A.F., M.H.B.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex (W.T.Y., B.D.); Department of Radiology, University of Texas Southwestern Medical Center at Dallas, Dallas, Tex (B.D., S.H.G.); Department of Radiology, University of Michigan, Ann Arbor, Mich (T.C.); Department of Surgery, University of California San Francisco, San Francisco, Calif (C.Y., L.J.E.); Department of Oncology and Hematology, University of Pennsylvania, Philadelphia, Pa (A.D.); and Berry Consultants, LLC, Austin, Tex (D.A.B.).
Abstract:
Background Suppression of background parenchymal enhancement (BPE) is commonly observed after neoadjuvant chemotherapy (NAC) at contrast-enhanced breast MRI. It was hypothesized that nonsuppressed BPE may be associated with inferior response to NAC. Purpose To investigate the relationship between lack of BPE suppression and pathologic response. Materials and Methods A retrospective review was performed for women with menopausal status data who were treated for breast cancer by one of 10 drug arms (standard NAC with or without experimental agents) between May 2010 and November 2016 in the Investigation of Serial Studies to Predict Your Therapeutic Response with Imaging and Molecular Analysis 2, or I-SPY 2 TRIAL (NCT01042379). Patients underwent MRI at four points: before treatment (T0), early treatment (T1), interregimen (T2), and before surgery (T3). BPE was quantitatively measured by using automated fibroglandular tissue segmentation. To test the hypothesis effectively, a subset of examinations with BPE with high-quality segmentation was selected. BPE change from T0 was defined as suppressed or nonsuppressed for each point. The Fisher exact test and the Z tests of proportions with Yates continuity correction were used to examine the relationship between BPE suppression and pathologic complete response (pCR) in hormone receptor (HR)-positive and HR-negative cohorts. Results A total of 3528 MRI scans from 882 patients (mean age, 48 years ± 10 [standard deviation]) were reviewed and the subset of patients with high-quality BPE segmentation was determined (T1, 433 patients; T2, 396 patients; T3, 380 patients). In the HR-positive cohort, an association between lack of BPE suppression and lower pCR rate was detected at T2 (nonsuppressed vs suppressed, 11.8% [six of 51] vs 28.9% [50 of 173]; difference, 17.1% [95% CI: 4.7, 29.5]; P = .02) and T3 (nonsuppressed vs suppressed, 5.3% [two of 38] vs 27.4% [48 of 175]; difference, 22.2% [95% CI: 10.9, 33.5]; P = .003). In the HR-negative cohort, patients with nonsuppressed BPE had lower estimated pCR rate at all points, but the P values for the association were all greater than .05. Conclusions In hormone receptor-positive breast cancer, lack of background parenchymal enhancement suppression may indicate inferior treatment response. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Philpotts in this issue.
More Related Videos
06:24Dynamic Contrast Enhanced Magnetic Resonance Imaging of an Orthotopic Pancreatic Cancer Mouse Model
Published on: April 18, 2015
08:36Ultrasound Imaging-guided Intracardiac Injection to Develop a Mouse Model of Breast Cancer Brain Metastases Followed by Longitudinal MRI
Published on: March 6, 2014