Breast-MRI-NACT-Pilot-EditThis

Detailed Description

Patient population

This pilot study to investigate the use of serial DCE MRI examinations during neoadjuvant chemotherapy for invasive breast cancer recruited 68 patients with stage II or III locally advanced breast cancer enrolled between 1995 and 2002 in an institutional review board (IRB)-approved research protocol.  All patients gave written informed consent to participate. All patients had confirmed breast cancer diagnoses based on histopathology of biopsy or surgical excision, and none had prior treatment with chemotherapy, surgery or radiation. All patients received pre-operative chemotherapy with four cycles of adriamycin-cytoxan administered every three weeks. A subset of 17 patients received additional weekly treatment with taxane after the Anthracycline regimen was completed. Three DCE-MRI scans were scheduled for all patients: MRI₁ before treatment; MRI₂ after one cycle of chemotherapy; MRI₃ after completion of Anthracycline treatment and before surgery or further treatment. Subjects receiving Taxane were scheduled for an additional exam, MRI₄, after completion of all chemotherapy treatment and before surgery.

Figure 1. UCSF Pilot NACT study schema. Only an N=17 subset of patients received Taxane and MRI₄ as a result of changes in standard of care during the course of the study. Note: Not all patients received core biopsies as indicated in this schema.

Exclusions: Of the 68 patients, four have been excluded from this collection: one did not undergo surgery, one did not have a pre-surgery time-point MRI, one was rejected due to unanalyzable MR images, and one had metastatic disease prior to the completion of treatment. None of the excluded patients were from the 17 subject Taxane group. Three patients are included here but may be excluded at researchers' discretion due to treatment anomalies: a) Two subjects in the Taxane group (UCSF_BR_30 and UCSF_BR_53) did not complete the Taxane treatment, but were moved directly to surgery early and did not have the final MRI₄ examination, and b) Patient UCSF_BR_27 declined standard-of-care post-surgery radiation and hormonal treatments. These cases are noted in the accompanying clinical information workbook.

Endpoint data: Recurrence-free survival (RFS) was assessed for each patient at 6-month or 1-year intervals following surgery. For patients that recurred, length of RFS was defined as the time from initial surgery to either local or distant recurrence. Other clinical and endpoint data includes patient age, lesion characteristics including pretreatment tumor size, histologic type, pathologic size, tumor subtype, and lymph node involvement. These data are included as supplemental information for the collection in the accompanying clinical information workbook.

MRI acquisition

Breast MRI was acquired on a 1.5-T scanner (Signa, GE Healthcare, Milwaukee, WI) using a bilateral phased array breast coil. The MR imaging protocol included a 3D localizer and a unilateral sagittal DCE acquisition. The DCE acquisition utilized a high spatial resolution, low temporal resolution, T1-weighted, fat-suppressed 3D fast gradient-recalled echo sequence developed for pre-surgical staging (TR/TE 8/4.2; flip angle 20 degrees; field of view 18-20 cm; acquisition matrix 256 x 192 x 60, section thickness 2 mm; spatial resolution 0.7 x 0.94 x 2.0 mm³). A minimum of three time points were acquired during each contrast-enhanced MRI protocol: a pre-contrast scan (t₀), followed by 2 consecutive post-contrast time points: early (t₁) and late (t₂) phases. The gadopentetate dimeglumine contrast agent (Magnevist, Bayer HealthCare, Berlin, Germany), was injected at a dose of 0.1 mmol/kg of body weight (injection rate = 1.2 mL per second) followed by a 10 mL saline flush, with injection starting coincident with the start of the early t₁ phase acquisition. Imaging time was approximately 5 minutes per acquisition, resulting in effective early and late post-contrast time points of 2.5 minutes and 7.5 minutes from the start of the contrast injection, respectively, using standard k-space sampling. Fat suppression was performed using a frequency-selective inversion recovery preparatory pulse.

Metadata

Excel workbook with clinical data and disease free survival (DFS) data for the 64 patients in this study:

Clinical and DFS Data (xls) 

DICOM data dictionary defining fields included in the 0x0117 private group for PE/SER calculation parameters and results, and deduced DCE scan timing information. NOTE: Dictionary contains sections for attributes from the I-SPY 1 TRIAL which are not included in this pilot study.:

ISPY-1 DCE MRI Data Sharing Dictionary_v2

Citations & Data Usage Policy 

This collection is freely available to browse, download, and use for commercial, scientific and educational purposes as outlined in the Creative Commons Attribution 3.0 Unported License.  See TCIA's Data Usage Policies and Restrictions for additional details. Questions may be directed to help@cancerimagingarchive.net.

Please be sure to include the following citations in your work if you use this data set:

Other Publications Using This Data

1: Partridge SC, Gibbs JE, Lu Y, Esserman LJ, Tripathy D, Wolverton DS, Rugo HS, Hwang ES, Ewing CA, Hylton NM. MRI measurements of breast tumor volume predict response to neoadjuvant chemotherapy and recurrence-free survival. AJR Am J Roentgenol. 2005 Jun;184(6):1774-81. PubMed PMID: 15908529.

2: Li KL, Partridge SC, Joe BN, Gibbs JE, Lu Y, Esserman LJ, Hylton NM. Invasive breast cancer: predicting disease recurrence by using high-spatial-resolution signal enhancement ratio imaging. Radiology. 2008 Jul;248(1):79-87. doi: 10.1148/radiol.2481070846. PubMed PMID: 18566170.

3: Hattangadi J, Park C, Rembert J, Klifa C, Hwang J, Gibbs J, Hylton N. Breast stromal enhancement on MRI is associated with response to neoadjuvant chemotherapy. AJR Am J Roentgenol. 2008 Jun;190(6):1630-6. doi: 10.2214/AJR.07.2533. PubMed PMID: 18492917.

4: Li KL, Henry RG, Wilmes LJ, Gibbs J, Zhu X, Lu Y, Hylton NM. Kinetic assessment of breast tumors using high spatial resolution signal enhancement ratio (SER) imaging. Magn Reson Med. 2007 Sep;58(3):572-81. PubMed PMID: 17685424; PubMed Central PMCID: PMC4508009.

5: Jones EF, Sinha SP, Newitt DC, Klifa C, Kornak J, Park CC, Hylton NM. MRI enhancement in stromal tissue surrounding breast tumors: association with recurrence free survival following neoadjuvant chemotherapy. PLoS One. 2013 May 7;8(5):e61969. doi: 10.1371/journal.pone.0061969. Print 2013. PubMed PMID: 23667451; PubMed Central PMCID: PMC3646993.

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Version 1 (Current): Updated 2016/01/30

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