Diffusion Tensor Imaging for Characterizing Changes in Triple-Negative Breast Cancer During Neoadjuvant Systemic Therapy

Authors

Benjamin C Musall
David E Rauch
Rania M M Mohamed
Bikash Panthi
Medine Boge
Rosalind P Candelaria
Huiqin Chen
Mary S Guirguis
Kelly K Hunt
Lei Huo
Ken-Pin Hwang
Anil Korkut
Jennifer K Litton
Tanya W Moseley
Sanaz Pashapoor
Miral M Patel
Brandy J Reed
Marion E Scoggins
Jong Bum Son
Debu Tripathy
Vicente Valero
Peng Wei
Jason B White
Gary J Whitman
Zhan Xu
Wei T Yang
Clinton Yam
Beatriz E Adrada
Jingfei Ma

Language

English

Publication Date

10-1-2024

Journal

Journal of Magnetic Resonance Imaging

DOI

10.1002/jmri.29267

PMID

38294179

PMCID

PMC11289164

PubMedCentral® Posted Date

10-1-2025

PubMedCentral® Full Text Version

Author MSS

Abstract

Background: Assessment of treatment response in triple-negative breast cancer (TNBC) may guide individualized care for improved patient outcomes. Diffusion tensor imaging (DTI) measures tissue anisotropy and could be useful for characterizing changes in the tumors and adjacent fibroglandular tissue (FGT) of TNBC patients undergoing neoadjuvant systemic treatment (NAST).

Purpose: To evaluate the potential of DTI parameters for prediction of treatment response in TNBC patients undergoing NAST.

Study type: Prospective.

Population: Eighty-six women (average age: 51 ± 11 years) with biopsy-proven clinical stage I-III TNBC who underwent NAST followed by definitive surgery. 47% of patients (40/86) had pathologic complete response (pCR).

Field strength/sequence: 3.0 T/reduced field of view single-shot echo-planar DTI sequence.

Assessment: Three MRI scans were acquired longitudinally (pre-treatment, after 2 cycles of NAST, and after 4 cycles of NAST). Eleven histogram features were extracted from DTI parameter maps of tumors, a peritumoral region (PTR), and FGT in the ipsilateral breast. DTI parameters included apparent diffusion coefficients and relative diffusion anisotropies. pCR status was determined at surgery.

Statistical tests: Longitudinal changes of DTI features were tested for discrimination of pCR using Mann-Whitney U test and area under the receiver operating characteristic curve (AUC). A P value < 0.05 was considered statistically significant.

Results: 47% of patients (40/86) had pCR. DTI parameters assessed after 2 and 4 cycles of NAST were significantly different between pCR and non-pCR patients when compared between tumors, PTRs, and FGTs. The median surface/average anisotropy of the PTR, measured after 2 and 4 cycles of NAST, increased in pCR patients and decreased in non-pCR patients (AUC: 0.78; 0.027 ± 0.043 vs. -0.017 ± 0.042 mm2/s).

Data conclusion: Quantitative DTI features from breast tumors and the peritumoral tissue may be useful for predicting the response to NAST in TNBC.

Evidence level: 1 TECHNICAL EFFICACY: Stage 4.

Keywords

Humans, Female, Middle Aged, Diffusion Tensor Imaging, Neoadjuvant Therapy, Triple Negative Breast Neoplasms, Prospective Studies, Adult, Treatment Outcome, Anisotropy, Breast, Aged, ROC Curve, Reproducibility of Results, Triple-negative Breast Cancer, Diffusion Tensor Imaging, Peritumoral Region, Treatment Response, Breast MRI

Published Open-Access

yes

Recommended Citation

Musall, Benjamin C; Rauch, David E; Mohamed, Rania M M; et al., "Diffusion Tensor Imaging for Characterizing Changes in Triple-Negative Breast Cancer During Neoadjuvant Systemic Therapy" (2024). Faculty, Staff and Student Publications. 5894.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/5894