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Breast-MRI-NACT-Pilot

This collection contains longitudinal DCE MRI studies of 64 patients undergoing neoadjuvant chemotherapy (NACT) for invasive breast cancer.

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.

This shared data set was provided by David Newitt, PhD and Nola Hylton, PhD from the Breast Imaging Research Program at UCSF.

This work was supported by grants:

National Institute of Health/National Cancer Institute: IUO1CA151235; RO1CA132870 Susan G Komen: SAC110017

Data and Resources