Early DCE-MRI Changes Predict Residual Enhancing Volume in Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy

Xia Li¹, Lori R. Arlinghaus¹, E. Brian Welch¹, A. Bapsi Chakravarthy¹, Lei Xu¹, Jaime Farley¹, Ingrid Mayer¹, Mark Kelley¹, Ingrid Meszoely¹, Julie Means-Powell¹, Vandana Abramson¹, Ana Grau¹, Mia Levy¹, John C. Gore¹, Thomas E Yankeelov¹

The response of breast tumors to chemotherapy is currently monitored by frank changes in tumor morphology. Unfortunately, it is difficult to quantify and often does not correlate with tumor activity. DCE-MRI can offer information related to tumor perfusion and permeability, vascular volume, and extravascular extracellular volume fraction. In this study, we use the extended Tofts model to return estimates on these parameters during neoadjuvant chemotherapy in breast cancer patients. We found a strong relationship among the early change in Ktrans and residual tumor burden, as well as the change in the enhancing volume of tumor tissue at conclusion of therapy.