Skip to main content
Open Access Publications from the University of California


UC San Francisco Previously Published Works bannerUCSF

Predicting breast cancer response to neoadjuvant treatment using multi-feature MRI: results from the I-SPY 2 TRIAL.

  • Author(s): Li, Wen;
  • Newitt, David C;
  • Gibbs, Jessica;
  • Wilmes, Lisa J;
  • Jones, Ella F;
  • Arasu, Vignesh A;
  • Strand, Fredrik;
  • Onishi, Natsuko;
  • Nguyen, Alex Anh-Tu;
  • Kornak, John;
  • Joe, Bonnie N;
  • Price, Elissa R;
  • Ojeda-Fournier, Haydee;
  • Eghtedari, Mohammad;
  • Zamora, Kathryn W;
  • Woodard, Stefanie A;
  • Umphrey, Heidi;
  • Bernreuter, Wanda;
  • Nelson, Michael;
  • Church, An Ly;
  • Bolan, Patrick;
  • Kuritza, Theresa;
  • Ward, Kathleen;
  • Morley, Kevin;
  • Wolverton, Dulcy;
  • Fountain, Kelly;
  • Lopez-Paniagua, Dan;
  • Hardesty, Lara;
  • Brandt, Kathy;
  • McDonald, Elizabeth S;
  • Rosen, Mark;
  • Kontos, Despina;
  • Abe, Hiroyuki;
  • Sheth, Deepa;
  • Crane, Erin P;
  • Dillis, Charlotte;
  • Sheth, Pulin;
  • Hovanessian-Larsen, Linda;
  • Bang, Dae Hee;
  • Porter, Bruce;
  • Oh, Karen Y;
  • Jafarian, Neda;
  • Tudorica, Alina;
  • Niell, Bethany L;
  • Drukteinis, Jennifer;
  • Newell, Mary S;
  • Cohen, Michael A;
  • Giurescu, Marina;
  • Berman, Elise;
  • Lehman, Constance;
  • Partridge, Savannah C;
  • Fitzpatrick, Kimberly A;
  • Borders, Marisa H;
  • Yang, Wei T;
  • Dogan, Basak;
  • Goudreau, Sally;
  • Chenevert, Thomas;
  • Yau, Christina;
  • DeMichele, Angela;
  • Berry, Don;
  • Esserman, Laura J;
  • Hylton, Nola M
  • et al.

Dynamic contrast-enhanced (DCE) MRI provides both morphological and functional information regarding breast tumor response to neoadjuvant chemotherapy (NAC). The purpose of this retrospective study is to test if prediction models combining multiple MRI features outperform models with single features. Four features were quantitatively calculated in each MRI exam: functional tumor volume, longest diameter, sphericity, and contralateral background parenchymal enhancement. Logistic regression analysis was used to study the relationship between MRI variables and pathologic complete response (pCR). Predictive performance was estimated using the area under the receiver operating characteristic curve (AUC). The full cohort was stratified by hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status (positive or negative). A total of 384 patients (median age: 49 y/o) were included. Results showed analysis with combined features achieved higher AUCs than analysis with any feature alone. AUCs estimated for the combined versus highest AUCs among single features were 0.81 (95% confidence interval [CI]: 0.76, 0.86) versus 0.79 (95% CI: 0.73, 0.85) in the full cohort, 0.83 (95% CI: 0.77, 0.92) versus 0.73 (95% CI: 0.61, 0.84) in HR-positive/HER2-negative, 0.88 (95% CI: 0.79, 0.97) versus 0.78 (95% CI: 0.63, 0.89) in HR-positive/HER2-positive, 0.83 (95% CI not available) versus 0.75 (95% CI: 0.46, 0.81) in HR-negative/HER2-positive, and 0.82 (95% CI: 0.74, 0.91) versus 0.75 (95% CI: 0.64, 0.83) in triple negatives. Multi-feature MRI analysis improved pCR prediction over analysis of any individual feature that we examined. Additionally, the improvements in prediction were more notable when analysis was conducted according to cancer subtype.

Many UC-authored scholarly publications are freely available on this site because of the UC's open access policies. Let us know how this access is important for you.

Main Content
For improved accessibility of PDF content, download the file to your device.
Current View