Intravoxel incoherent motion (IVIM) histogram biomarkers for prediction of neoadjuvant treatment response in breast cancer patients Journal Article

Authors: Cho, G. Y.; Gennaro, L.; Sutton, E. J.; Zabor, E. C.; Zhang, Z.; Giri, D.; Moy, L.; Sodickson, D. K.; Morris, E. A.; Sigmund, E. E.; Thakur, S. B.
Article Title: Intravoxel incoherent motion (IVIM) histogram biomarkers for prediction of neoadjuvant treatment response in breast cancer patients
Abstract: Objective To examine the prognostic capabilities of intravoxel incoherent motion (IVIM) metrics and their ability to predict response to neoadjuvant treatment (NAT). Additionally, to observe changes in IVIM metrics between pre- and post-treatment MRI. Methods This IRB-approved, HIPAA-compliant retrospective study observed 31 breast cancer patients (32 lesions). Patients underwent standard bilateral breast MRI along with diffusion-weighted imaging before and after NAT. Six patients underwent an additional IVIM-MRI scan 12–14 weeks after initial scan and 2 cycles of treatment. In addition to apparent diffusion coefficients (ADC) from monoexponential decay, IVIM mean values (tissue diffusivity Dt, perfusion fraction fp, and pseudodiffusivity Dp) and histogram metrics were derived using a biexponential model. An additional filter identified voxels of highly vascular tumor tissue (VTT), excluding necrotic or normal tissue. Clinical data include histology of biopsy and clinical response to treatment through RECIST assessment. Comparisons of treatment response were made using Wilcoxon rank-sum tests. Results Average, kurtosis, and skewness of pseudodiffusion Dp significantly differentiated RECIST responders from nonresponders. ADC and Dt values generally increased (∼70%) and VTT% values generally decreased (∼20%) post-treatment. Conclusion Dp metrics showed prognostic capabilities; slow and heterogeneous pseudodiffusion offer poor prognosis. Baseline ADC/Dt parameters were not significant predictors of response. This work suggests that IVIM mean values and heterogeneity metrics may have prognostic value in the setting of breast cancer NAT. © 2017 The Author(s)
Keywords: breast cancer; neoadjuvant treatment; diffusion weighted mri; response evaluation criteria in solid tumors; intravoxel incoherent motion
Journal Title: European Journal of Radiology Open
Volume: 4
ISSN: 2352-0477
Publisher: Elsevier Inc.  
Date Published: 2017-01-01
Start Page: 101
End Page: 107
Language: English
DOI: 10.1016/j.ejro.2017.07.002
PROVIDER: scopus
PMCID: PMC5565789
PUBMED: 28856177
Notes: Article -- Export Date: 5 September 2017 -- Source: Scopus
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MSK Authors
  1. Zhigang Zhang
    244 Zhang
  2. Dilip D Giri
    123 Giri
  3. Elizabeth A Morris
    247 Morris
  4. Emily Craig Zabor
    131 Zabor
  5. Sunitha Bai Thakur
    42 Thakur
  6. Elizabeth Jane Sutton
    26 Sutton
  7. Gene Young Cho
    4 Cho