Christof Boehm¹, Jonathan K. Stelter¹, Jakob Meineke², Stefan Ruschke¹, Kilian Weiss³, Mingming Wu¹, Tabea Borde¹, Marcus R. Makowski¹, Eva M. Fallenberg¹, and Dimitrios C. Karampinos^1
1Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany, ²Philips Research, Hamburg, Germany, ³Philips GmbH Market DACH, Hamburg, Germany

Early stage malignant tumors are often accompanied by microcalcifications. X-ray-based mammography examinations are routinely used for screening and early detection due to the excellent contrast of calcified structures. However, due to the damaging nature of x-ray radiation, the use of an MR-based technique would be desirable for repeated examinations. In this work, we present initial results of quantitative-susceptibility-mapping-based (QSM) mammography-like MR-images that show robust detection of calcifications down to the resolution of the MR scan. Furthermore, the proposed method accounts for the potential presence of silicone breast implants allowing robust QSM in proximity to silicone implants for the first time.

Timothy J Allen¹, Leah C Henze Bancroft², Ersin Bayram³, Lloyd Estkowski⁴, Pingni Wang⁵, Ty A Cashen⁶, and James H Holmes^7
1Medical Physics, University of Wisconsin-Madison, Madison, WI, United States, ²Radiology, University of Wisconsin-Madison, Madison, WI, United States, ³GE Healthcare, Houston, TX, United States, ⁴GE Healthcare, Waukesha, WI, United States, ⁵GE Healthcare, Menlo Park, CA, United States, ⁶GE Healthcare, Madison, WI, United States, ⁷Radiology, University of Iowa, Iowa City, IA, United States

We investigate the use of a deep neural network to automatically position imaging volumes for breast MR exams. The axial localizer images and scan volume information from a variety of MR scanners were used to train a deep neural network to replicate the clinical technologists’ placement. The average intersection over union between clinical placement and neural network predicted placement was 0.46 ± 0.21. The distance between volume centers was 7.4 cm on average and as low as 1.1 cm. These results show promise for improving consistency of imaging volume placement in breast MRI.

Nu N. Le¹, Wen Li¹, Natsuko Onishi¹, David Newitt¹, Jessica Gibbs¹, Lisa Wilmes¹, John Kornak², Savannah C. Partridge³, Elissa Price¹, Bonnie N. Joe¹, Laura Esserman², and Nola M. Hylton^1
1Radiology, UCSF, San Francisco, CA, United States, ²UCSF, San Francisco, CA, United States, ³University of Washington, Seattle, WA, United States

This study presents a retrospective analysis of inter-reader variability in tumor ADC measurements extracted from three types of ROIs using data from the multi-center I-SPY 2 trial. Overall, good agreement was observed between two readers. Mean ADCs measured in restricted ROIs were highly reproducible by manual delineation. Mean ADCs of multi-slice restricted ROIs showed higher ICCs than single-slice restricted ROIs.

Patriek Jurrius^1,2, Omar Darwish^3,4,5, Daniel Fovargue³, Belul Shifa⁶, Karen Welsh⁷, Joanna Bell⁷, Sarah-Jane Hamilton⁷, John Spence⁷, Giacomo Annio⁴, Renee Miller³, Marian Troelstra³, Ashutosh Kothari², Hisham Hamed², Georgina Bitsakou², Ali Sever⁸, Sultana Hasso⁸, Yasmin Giambrone⁸, Isaac Daimiel Naranjo⁸, Katerina Ntailiani⁸, Keshthra Satchithananda⁹, Sarah Willson⁸, Sarah Pinder^1,10, Anne Rigg¹¹, David Nordsletten³, Radhouene Neji^3,5, Tony Ng¹, Arnie Purushotham^1,2, and Ralph Sinkus^3,4
1School of Cancer & Pharmaceutical Sciences, King's College London, London, United Kingdom, ²Oncoplastic breast surgery, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom, ³School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom, ⁴Inserm U1148, LVTS, University Paris Diderot, Paris, France, ⁵MR Research Collaborations, Siemens Healthcare Ltd., Frimley, United Kingdom, ⁶Oncology and Haematology Clinical Trials, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom, ⁷MRI department, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom, ⁸Breast Radiology, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom, ⁹Breast Radiology, King's College Hospital NHS Foundation, London, United Kingdom, ¹⁰Histopathology, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom, ¹¹Medical Oncology, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom

Approximately one-third of women with breast cancer undergoing neoadjuvant chemotherapy (NACT) have no discernible disease response to their treatment yet are subjected to the potential side-effects of their treatment. Currently, response to NACT is assessed by determining tumour size, contrast avidity, and lymph node involvement on MRI pre-, mid- and post-treatment. As a result, women undergo 3-4 cycles of NACT with unknown efficacy. Changes in a tumour’s biomechanics as assessed by magnetic resonance elastography (MRE) after only one cycle of NACT correlate with response to treatment, allowing for early assessment of a patient’s response to NACT.

Bin Deng^1,2,3, Ailis Muldoon^1,2, Pedro Itriago⁴, Wei-Ching Lo⁵, Mansi Saksena^2,3, Samuel Patz^3,6, Ralph Sinkus⁷, Steven J. Isakoff^3,8, and Stefan A. Carp^1,2,3
1Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States, ²Department of Radiology, Massachusetts General Hospital, Boston, MA, United States, ³Harvard Medical School, Boston, MA, United States, ⁴Siemens Medical Solutions, Houston, TX, United States, ⁵Siemens Medical Solutions, Boston, MA, United States, ⁶Department of Radiology, Brigham and Women’s Hospital, Boston, MA, United States, ⁷Laboratory for Vascular Translational Science (LVTS), Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France, ⁸Cancer Center, Massachusetts General Hospital, Boston, MA, United States

Functional imaging is advantageous in monitoring neoadjuvant chemotherapy (NACT) since changes in tumor physiology manifest earlier than actual tumor shrinkage. We leveraged a custom breast coil for multimodal T1, DWI, MRE, and near-infrared optical imaging to evaluate the response of breast tumors to NACT. In this case study of a patient who achieved pathologic complete response, concordant changes in tumor size, ADC, stiffness and total hemoglobin concentration have been observed. This multiparametric approach could help us gain a comprehensive understanding of the multitude of simultaneous physiological changes in tumors related to microenvironment, angiogenesis, and metabolism as a result of NACT.

Wen Li¹, Rohan Nadkarni¹, David C Newitt¹, Natsuko Onishi¹, Jessica Gibbs¹, Lisa J Wilmes¹, Bonnie N Joe¹, Efstathios D Gennates², John Kornak², Mark Magbanua³, Laura van't Veer³, Barbara LeStage⁴, I-SPY 2 Consortium⁵, Laura J Esserman⁶, and Nola M Hylton^1
1Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States, ²Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, United States, ³Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United States, ⁴I-SPY 2 Advocacy Group, San Francisco, CA, United States, ⁵Quantum Leap Healthcare Collaborative, San Francisco, CA, United States, ⁶Surgery, University of California, San Francisco, San Francisco, CA, United States

Functional tumor volume (FTV) has been used to longitudinally assess tumor response to neoadjuvant therapy longitudinally in I-SPY trials. Previously, we found that a single 3D shape feature, sphericity, is associated with pathologic complete response (pCR). In this study, we expanded the analysis by including all radiomic shape features in an elastic net model and evaluated their role in prediction of pCR in the multi-center I-SPY 2 trial. Our results showed that the model with shape features outperformed the models with FTV  or sphericity alone.

Keith S Cover^1
1., Amsterdam, Netherlands

The current analysis found MRI screening in the DENSE trial detected invasive breast cancers about 6 years earlier than mammography. The calculation is based on first and second round invasive cancer detection rates. The 6 years is also consistent with the trial’s high false positive rate in the second round that used “prior” first round exams to estimate lesion growth over the 2 years between rounds. The “how much earlier” measure provides an additional means for comparing the relative performance of breast cancer screening modalities.  

Zhiqiang Chen¹, Na Song¹, Dan Zhang¹, Zhuo Wang¹, Shaoru Zhang¹, Yuhui Xiong², Aijun Wang¹, Bing Chen¹, and Lei Cai^1
1Radiology, The Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, China, ²GE Healthcare, MR Research China, Beijing, Beijing, China

In this retrospective study, we aim to explore the diagnostic values of diffusion tensor imaging (DTI) in peripheral prostate cancer, and compare DTI with diffusion weighted imaging (DWI) based on prostate imaging reporting and data system version 2 (PI-RADS v2) in peripheral prostate cancer (PCa). It was concluded that both DWI and DTI have high values in the diagnosis and differentiation of PCa, and DWI& dynamic contrast enhanced (DCE) MRI has higher diagnostic efficiency than DTI&DCE-MRI according to PI-RADS v2.