Abstract #0203

Apparent diffusion coefficient as a non-contrast marker of residual disease after breast neoadjuvant treatment

Patrick J Bolan¹, Wen Li², Bonnie N Joe², Nu Le², Elissa Price², Jessica Gibbs², Lisa J Wilmes², Debsmita Biswas³, Anum Kazerouni³, An L Church⁴, Elizabeth S McDonald⁵, Stephane Loubrie⁶, Rebecca Rakow-Penner⁶, Hon J Yu⁶, Dariya Malyarenko⁷, Thomas L Chenervert⁷, Beatriu Reig⁸, Nola M Hylton², and Savannah Partridge³

¹Center for MR Research / Radiology, University of Minnesota, MINNEAPOLIS, MN, United States, ²Radiology, University of California San Francisco, San Francisco, CA, United States, ³University of Washington, Seattle, WA, United States, ⁴Radiology, University of Minnesota, MINNEAPOLIS, MN, United States, ⁵Radiology, University of Pennsylvania, Philadelphia, PA, United States, ⁶Radiology, University of Californa San Diego, San Diego, CA, United States, ⁷Radiology, University of Michigan, Ann Arbor, MI, United States, ⁸Radiology, New York University, New York, NY, United States

Synopsis

Keywords: Breast, Treatment, Cancer, Treatment Response

Motivation: Accurate imaging markers to establish pathologic complete response (pCR) during neoadjuvant chemotherapy (NACT) could enable therapy de-escalation to avoid excessive systemic treatments

Goal(s): To determine if quantitative diffusion-weighted MRI (DWI) can accurately detect pCR following NACT.

Approach: In the ACRIN 6698/I-SPY 2 multicenter trial dataset, tumor region apparent diffusion coefficient (ADC) from DWI was measured on post-NACT/presurgical MRIs. The accuracy of ADC for predicting pCR, alone and in combination with functional tumor volume (FTV) from contrast-enhanced MRI, was assessed.

Results: In multivariate models ADC accurately predicts pCR, and is influenced by field strength, spatial resolution, and lesion morphology.

Impact: Apparent diffusion coefficient measured by DWI shows promise for determining absence of residual disease following chemotherapy and may provide a non-contrast option for tailoring therapies and enabling patients to avoid unnecessary prolongation of treatment.

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