Predicting the Early Response to Neoadjuvant Therapy with Breast MR Morphological, Functional and Relaxometry...

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Early prediction of treatment response in breast cancer is crucial for optimizing neoadjuvant therapy (NAT).
• Current methods for assessing early response have limitations.
• MR relaxometry offers a novel approach to quantitatively evaluate tissue properties.

Purpose of the Study:

• To evaluate the role of MR relaxometry and proton density analysis in predicting early treatment response to NAT in breast cancer patients.
• To determine if specific relaxometry parameters can identify responders versus non-responders after two cycles of NAT.

Main Methods:

• Prospective study of 59 breast cancer patients undergoing MRI before (MRI1) and after two NAT cycles (MRI2).
• MR relaxometry maps and seven derived parameters were obtained from MRI1.
• Histopathology, T2 features, and ADC values were also analyzed.
• Response was defined by size changes on MRI2.

Main Results:

• 50 patients (79.3%) responded to NAT, while 13 (20.7%) did not.
• Nodal status (N0 vs. N2) was associated with response (p=0.005).
• T2 min relaxometry value showed association with response (p=0.017), with an AUC of 0.715.
• A combined model of T2 min and N stage achieved a higher AUC of 0.826 (p<0.001).

Conclusions:

• MR relaxometry, particularly T2 min values, shows potential as a tool for predicting early treatment response in breast cancer patients undergoing NAT.
• Combining T2 min relaxometry with nodal status significantly improves prediction accuracy.
• This quantitative imaging approach may aid in tailoring breast cancer treatment strategies.