Abstract P4-02-08: Repeatability and reproducibility of quantitative breast MRI in community imaging centers: Preliminary results
Authors: Sorace AG , Virostko J , Wu C , Jarrett AM , Barnes SL , Luci J , Patt DA , Goodgame B , Avery S , Yankeelov TE 
Published: February 2018

Introduction: The primary purpose of this study is to evaluate the repeatability and reproducibility of quantitative breast MRI across community imaging centers with the ultimate goal of using these techniques to predict breast cancer response early in the course of neoadjuvant therapy (NAT). Dynamic contrast-enhanced MRI (DCE-MRI), diffusion-weighted MRI (DW-MRI), and magnetization transfer MRI (MT-MRI) performed early in the course of breast NAT has the potential to predict eventual response prior to changes in tumor size. This enables tailoring of treatment plans and the opportunity to substitute ineffective therapies with alternative approaches. We present preliminary results on the reproducibility and repeatability of T1, apparent diffusion coefficient (ADC), and magnetization transfer ratio (MTR) measurements in normal breast fibroglandular tissue (FGT) in the community setting.

Experimental Design: MRI was performed at two community imaging centers and one academic research facility using 3T Siemens Skyra scanners equipped with 8- or 16-channel breast coils. To assess repeatability of the imaging techniques, normal subjects (N=10, ages 22-62) were scanned twice, separated by subject repositioning. To assess reproducibility across sites, normal subjects (N=3) were scanned at three imaging centers. To assess quantitative T1 measurements, subjects were scanned using a spoiled gradient echo (SPGE) sequence and variable flip angles (2, 4, 6, …, 20) with TR/TE = 7.9/2.71 ms and corrected for B1inhomogeneity. To assess the ADC, subjects were scanned using an echo-planar monopolar spin echo sequence with the following parameters: TR/TE = 3000/52 ms and b-values = 0, 200, 800 s/mm2. MT-MRI was acquired using two gradient echo sequences with TR/TE = 48.0/6.40 ms, one with the inclusion of a 1500 Hz off-resonance saturation pulse. FGT was segmented using k-means clustering. Women undergoing NAT for breast cancer are being recruited and scanned with DCE-MRI, DW-MRI, and MT-MRI at baseline (prior to beginning therapy) and three early time points during the course of NAT to evaluate early prediction of response to therapy.

Results: Reproducibility scans of normal breast FGT yielded an average difference of 8.4% in T1 measurement, 7.0% in ADC measurement, and 12.7% in MTR measurement between sites. Repeatability scans of the same subject's FGT showed an average percent difference of 6.7% in T1 measurement, 4.5% in ADC measurement, and 11.6% in MTR measurement between the two scans. A multi-site trial performing quantitative DCE-MRI, DW-MRI, and MT-MRI in patients undergoing breast NAT in the community setting (N=16 at the time of submission) has been ongoing to predict response to NAT using quantitative MRI.

Conclusion: Quantitative DCE-, DW-, and MT-MRI of the breast is both repeatable and reproducible across MRI scanners in community imaging centers. A quantitative breast MRI protocol can be deployed at community imaging centers for breast cancer patients. These results and ongoing work highlight the feasibility of future clinical dissemination of quantitative MRI for predicting early response to NAT, therefore expanding these novel techniques to a widespread patient population.

We acknowledge the support of CPRIT RR160005.

Citation Format: Sorace AG, Virostko J, Wu C, Jarrett AM, Barnes SL, Luci J, Patt DA, Goodgame B, Avery S, Yankeelov TE. Repeatability and reproducibility of quantitative breast MRI in community imaging centers: Preliminary results [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-02-08.