ISMRM 23rd Annual Meeting & Exhibition • 30 May - 05 June 2015 • Toronto, Ontario, Canada

Scientific Session • Cancer: Therapy Response & Perfusion

Wednesday 3 June 2015

Room 701 A

13:30 - 15:30


Nandita M. DeSouza, M.D., F.R.C.R., Natalie J. Serkova, Ph.D.

13:30   Introduction
Sungheon Kim
13:42 0604.   Quantitative DCE-MRI Evaluation of Breast Cancer Response to Neoadjuvant Chemotherapy
Alina Tudorica1, Karen Y Oh1, Stephen Y-C Chui1, Nicole Roy1, Megan L Troxell1, Arpana Naik1, Kathleen A Kemmer1, Yiyi Chen1, Megan L Holtorf1, Aneela Afzal1, Charles S Springer1, Xin Li1, and Wei Huang1
1Oregon Health & Science University, Portland, OR, United States

21 women with locally advanced breast cancer underwent DCE-MRI scans before, after the first cycle of, at the midpoint of, and after completion of neoadjuvant chemotherapy. Quantitative DCE-MRI parameters of Ktrans, kep, and Tau_i were found to be superior to tumor size measurement for early prediction of pathologic response. DCE-MRI parameters were as good as tumor size, if not better, in evaluation of residual disease burden after the therapy.

13:54 0605.   Dynamic-Contrast-Enhanced MRI and Dynamic Tensor Imaging (DTI) for the Early Detection of Anti-angiogenic Effect and Vessel “Normalization” in Human Breast Cancer Treated with Neoadjuvant Chemotherapy - permission withheld
Thian Ng1,2, Bo Zhang3, Dennis Cheong4, Limiao Jiang5, Bingwen Zheng6, and Soo Chin Lee7
1National University of Singapore, S'pore, Singapore, Singapore, 2CIRC/A*STAR, S'pore, Singapore, Singapore, 3CIRC/A*STAR, Singapore, Singapore,4CIRC/A*STAR, S'pore, Singapore, 5NUS/CIRC, S'pore, Singapore, 6NUS/NERI, S'pore, Singapore, 7NUS, S'pore, Singapore

This is a clinical trial study on advanced breast carcinoma using low-dose Sunitinib to 'Normalization' the microvascular environment to enhance the delivery of anti-cancer drugs (AC)to the cancer cells. In vivo DCE-MRI and DTI are used to monitor the perfusion,and 4 other vessel parameters changes prior to the main course of chemotherapy to reveal the most sensitive biomarker(s)with respect to tumor mass by MRI. Other histological parameters are measured.

14:06 0606.   Optimization of DCE-MRI measurement parameters for predicting response to neoadjuvant chemotherapy by breast cancer subtype
Wen Li1, Wei-Ching Lo1, Ella F Jones1, David C Newitt1, John Kornak2, Lisa J Wilmes1, and Nola M Hylton1
1Radiology and Biomedical Imaging, UCSF, San Francisco, CA, United States, 2Epidemiology and Biostatistics, UCSF, San Francisco, CA, United States

This abstract presents our retrospective study of parameter optimization for tumor volume measurement in DCE-MRI to predict response to neoadjuvant chemotherapy by breast cancer subtype in clinical trials. Pilot study consisting of 64 patients was used to test the proposed optimization strategy. Two standard clinical outcomes were used to assess the prediction. Results showed that different profile was observed for different breast cancer subtype when the prediction was evaluated on a matrix of parameter settings and the predictive performance of tumor volume measured in DCE-MRI can be improved with parameter optimization.

14:18 0607.   3D Texture Analysis of DCE-MRI Pharmacokinetic Parametric Maps for Early Prediction of Breast Cancer Therapy Response
Guillaume Thibault1, Alina Tudorica1, Aneela Afzal1, Stephen Y-C Chui1, Arpana Naik1, Megan L Troxell1, Kathleen A Kemmer1, Karen Y Oh1, Nicole Roy1, Megan L Holtorf1, Wei Huang1, and Xubo Song1
1Oregon Health & Science University, Portland, OR, United States

Twenty-eight women with locally advanced breast cancer who underwent neoadjuvant chemotherapy (NACT) consented to research DCE-MRI studies before, during, and after NACT. The DCE-MRI data were subjected to both Standard and Shutter-Speed model (SM and SSM) pharmacokinetic (PK) analyses to generate pixel-by-pixel parametric maps. Three texture analysis methods were employed to extract triple features from the maps and their changes after one NACT cycle were correlated with residual cancer burden (RCB) measured by pathology analysis of post-NACT resection specimens. Texture feature changes in several PK parametric maps provided good early prediction of therapy response, with the SSM maps the most frequently used in feature extraction with good early prediction of response.

14:30 0608.   Neoadjuvant Chemotherapy Treatment Prediction: A Classification Model Based Approach Utilising Pre-treatment DCE-MRI
Martin D Pickles1, Peter Gibbs1, Martin Lowry1, and Lindsay W Turnbull1
1Centre for Magnetic Resonance Investigations, Hull York Medical School at University of Hull, Hull, East Yorkshire, United Kingdom

The aim of this work was to develop a classification model to predict pCR, in patients undergoing neoadjuvant chemotherapy. To generate empirical vascular parameters dynamic data was interrogated in a pixel-by-pixel manner. Following pathological analysis Synthetic Minority Over-sampling TEchnique (SMOTE) was utilised to balance the pCR and non-pCR classes and a classification model was developed. High predictive accuracy was obtained from only 4 DCE-MRI parameters. This study suggests that prediction of pathological complete response, secondary to NAC treatment, can be made even prior to the initiation of chemotherapy from DCE-MRI parameters with a 86% accuracy.

14:42 0609.   
Improved Fitting of Breast Pharmacokinetic Parameters using Dispersion Models
Subashini Srinivasan1, Brian A Hargreaves1, and Bruce L Daniel1
1Department of Radiology, Stanford University, Palo Alto, California, United States

Quantitative pharmacokinetic mapping of breast DCE MRI is often performed using a Tofts model and requires the measurement of arterial input function. The measured or modeled AIF in a distant artery is assumed to be identical to the tumor tissue’s input. However, angiogenesis can delay and disperse the AIF resulting in poor model fitting and errors in pharmacokinetic mapping. In this study, the fitting of pharmacokinetic parameters using two different dispersion models was compared to use of a Tofts model without dispersion in 10 patients. The goodness-of-fit was considerably improved using dispersion models and may improve the accuracy of tumor characterization and treatment response.

14:54 0610.   
High plasma flow as measured using DCE-MRI and the 2CXM is associated with increased disease-free survival in patients with carcinoma of the cervix
Ben R Dickie1, Lucy E Kershaw1, Stephanie Withey2, Bernadette M Carrington3, Catharine M West4, and Chris J Rose5
1Medical Physics and Engineering, Christie NHS Foundation Trust, Manchester, United Kingdom, 2RRPPS, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom, 3Department of Radiology, Christie NHS Foundation Trust, Manchester, United Kingdom, 4Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom, 5Centre for Imaging Sciences, University of Manchester, Manchester, United Kingdom

DCE-MRI studies of cervical cancer have reported that Tofts model-derived Ktrans may predict outcome. Since Ktrans depends on both microvascular perfusion and permeability, it is unclear whether one or both are important for predicting survival. We present what we believe to be the first prospective DCE-MRI study (n = 42) to employ the more specific two-compartment exchange model (2CXM) to separately measure perfusion (plasma flow) and permeability, and study their relationship to disease-free survival. High plasma flow (P = 0.022) and low FIGO stage (P = 0.020) were significant predictors of survival, but permeability was not (P = 0.63).

15:06 0611.   Outcome Results of In-Bore MRI-Guided Laser Ablation for Malignant Renal Neoplasms: 1-Year Median Follow Up Analysis of 23 Treated Tumors
Sherif G Nour1,2, Andrew David Nicholson3, Tracy E Powell2,3, and Viraj Master3
1Emory University, Atlanta, GA, United States, 2Interventional MRI Program, Emory University, GA, United States, 3Emory University, GA, United States

This investigation describes the technical aspects of using laser fibers to deliver ablative energy to renal tumors during interactive MRI guidance and reports patient tolerance, complication rates, long term efficacy of laser ablation of renal malignancies. The technique represents a considerable departure from the complex handling of cryo- and RFA probes within the MRI environment and is likely to facilitate future dissemination of MRI-guided renal ablation. The procedure is well tolerated with a high safety profile. Long-term follow up results for up to >32 months point to an efficacious ablative technique with no residual or recurrent neoplasms in our series.

15:18 0612.   
Noninvasive assessment of functional tumor microvasculature and drug delivery associated with angiotensin receptor blockade in pancreatic cancer
Vidhya Kumar1,2, Yves Boucher3, Diego Ferreira1, Hao Liu3, Rakesh Jain3, and Alexander R Guimaraes1,4
1Radiology, Martinos Center for Biomedical Imaging, Charlestown, MA, United States, 2The Ohio State University, Columbus, OH, United States, 3Radiation Oncology/Steele Lab for Tumor Biology, Massachusetts General Hospital, Charlestown, MA, United States, 4Radiology, Oregon Health Sciences University, Portland, OR, United States

MRI using FDA approved magnetic nanoparticles allows a robust steady state technique that unlike intravital and confocal microscopy, is readily translatable to humans and scalable from mice to humans. The aim of this study was to develop and apply MRI based methods at interrogating tumor microvasculature in an established orthotopic pancreatic cancer model, and assess if angiotensin receptor blockade demonstrates quantificable changes in tumor microvasculature in addition to changes in drug delivery as measured by 18F-5fluorouracil.