Towards detection of early response in neoadjuvant chemotherapy of breast cancer using Bayesian intravoxel incoherent motion

Sai Man Cheung; Wing-Shan Wu; Nicholas Senn; Ravi Sharma; Trevor McGoldrick; Tanja Gagliardi; Ehab Husain; Yazan Masannat; Jiabao He

doi:10.3389/fonc.2023.1277556

Towards detection of early response in neoadjuvant chemotherapy of breast cancer using Bayesian intravoxel incoherent motion

Front Oncol. 2023 Dec 6:13:1277556. doi: 10.3389/fonc.2023.1277556. eCollection 2023.

Authors

Sai Man Cheung¹, Wing-Shan Wu¹, Nicholas Senn¹, Ravi Sharma², Trevor McGoldrick², Tanja Gagliardi^{1

3}, Ehab Husain⁴, Yazan Masannat⁵, Jiabao He^{1

6}

Affiliations

¹ Institute of Medical Sciences, School of Medicine, University of Aberdeen, Aberdeen, United Kingdom.
² Department of Oncology, Aberdeen Royal Infirmary, Aberdeen, United Kingdom.
³ Department of Radiology, Royal Marsden Hospital, London, United Kingdom.
⁴ Department of Pathology, Aberdeen Royal Infirmary, Aberdeen, United Kingdom.
⁵ Breast Unit, Aberdeen Royal Infirmary, Aberdeen, United Kingdom.
⁶ Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.

Abstract

Introduction: The early identification of good responders to neoadjuvant chemotherapy (NACT) holds a significant potential in the optimal treatment of breast cancer. A recent Bayesian approach has been postulated to improve the accuracy of the intravoxel incoherent motion (IVIM) model for clinical translation. This study examined the prediction and early sensitivity of Bayesian IVIM to NACT response.

Materials and methods: Seventeen female patients with breast cancer were scanned at baseline and 16 patients were scanned after Cycle 1. Tissue diffusion and perfusion from Bayesian IVIM were calculated at baseline with percentage change at Cycle 1 computed with reference to baseline. Cellular proliferative activity marker Ki-67 was obtained semi-quantitatively with percentage change at excision computed with reference to core biopsy.

Results: The perfusion fraction showed a significant difference (p = 0.042) in percentage change between responder groups at Cycle 1, with a decrease in good responders [-7.98% (-19.47-1.73), n = 7] and an increase in poor responders [10.04% (5.09-28.93), n = 9]. There was a significant correlation between percentage change in perfusion fraction and percentage change in Ki-67 (p = 0.042). Tissue diffusion and pseudodiffusion showed no significant difference in percentage change between groups at Cycle 1, nor was there a significant correlation against percentage change in Ki-67. Perfusion fraction, tissue diffusion, and pseudodiffusion showed no significant difference between groups at baseline, nor was there a significant correlation against Ki-67 from core biopsy.

Conclusion: The alteration in tumour perfusion fraction from the Bayesian IVIM model, in association with cellular proliferation, showed early sensitivity to good responders in NACT.

Clinical trial registration: https://clinicaltrials.gov/ct2/show/NCT03501394, identifier NCT03501394.

Keywords: cellularity; diffusion; microcirculation; pathological response; perfusion fraction.

Associated data

ClinicalTrials.gov/NCT03501394

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The study was jointly funded by the National Health Service Grampian Endowment Research Fund (16/11/047), Friends of Aberdeen and North Centre for Haematology, Oncology and Radiotherapy (RS17 004) and Tenovus Scotland (G16.09). SMC PhD study was jointly supported by Elphinstone scholarship, Roland Sutton Academic Trust and John Mallard scholarship and is currently funded by Cancer Research UK (C68628/A28312). NS PhD study was supported by Biotechnology and Biological Sciences Research Council (1654748, BB/M010996/1). The funding sources were not involved in the study design, in the collection, analysis and interpretation of data, in the writing of the report nor in the decision to submit the article for publication.