Tess E. Catherwood1, Andrew J. Patterson1, Kamarul Zaki2, Mahesh Iddawela2, Helena Earl2, Carlos Caldas3, Karen Sayal4, Martin John Graves1, Fiona J. Gilbert1
1Radiology, University of Cambridge, NHS Foundation Trust, Cambridge, United Kingdom; 2Oncology, Addenbrooke's Hospital and University of Cambridge, NHS Foundation Trust, Cambridge, United Kingdom; 3Cancer Research UK Cambridge Institute, Cambridge, United Kingdom; 4University of Cambridge, Cambridge, United Kingdom
Tumor heterogeneity is well recognized in breast cancer and is associated with differential responses to chemotherapy. Voxel-wise analysis of sequential DCE-MRI requires that images be spatially registered. Patients were studied with 3T MRI during neoadjuvant chemotherapy. Mutual information-based rigid and non-rigid registration was used to align dynamic and sequential volumes to account for motion artifacts and larger inter-session deformations. Semi-quantitative perfusion metrics were extracted and generation of spatially registered parameter maps allowed voxel-wise assessment of treatment response. This approach provides an insight into tumor microstructure and physiology and developments will ideally increase statistical sensitivity in differentiating responders and non-responders.