Current and emerging quantitative magnetic resonance imaging methods for assessing and predicting the response of breast cancer to neoadjuvant therapy

Abstract

Richard G Abramson,1,2,9 Lori R Arlinghaus,1,2 Jared A Weis,1,2 Xia Li,1,2 Adrienne N Dula,1,2 Eduard Y Chekmenev,1–4,9 Seth A Smith,1–3,5 Michael I Miga,1–3,6 Vandana G Abramson,7,9 Thomas E Yankeelov1–3,5,8,91Institute of Imaging Science, 2Department of Radiology and Radiological Sciences, 3Department of Biomedical Engineering, 4Department of Biochemistry, 5Department of Physics, 6Department of Neurosurgery, 7Department of Medical Oncology, 8Department of Cancer Biology, 9Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville,TN, USAAbstract: Reliable early assessment of breast cancer response to neoadjuvant therapy (NAT) would provide considerable benefit to patient care and ongoing research efforts, and demand for accurate and noninvasive early-response biomarkers is likely to increase. Response assessment techniques derived from quantitative magnetic resonance imaging (MRI) hold great potential for integration into treatment algorithms and clinical trials. Quantitative MRI techniques already available for assessing breast cancer response to neoadjuvant therapy include lesion size measurement, dynamic contrast-enhanced MRI, diffusion-weighted MRI, and proton magnetic resonance spectroscopy. Emerging yet promising techniques include magnetization transfer MRI, chemical exchange saturation transfer MRI, magnetic resonance elastography, and hyperpolarized MR. Translating and incorporating these techniques into the clinical setting will require close attention to statistical validation methods, standardization and reproducibility of technique, and scanning protocol design.Keywords: treatment response, presurgical treatment, neoadjuvant chemotherapy