| 08:15 | 0406.
 | Initial evaluation of breast MRI protocols for cancer treatment monitoring at low field 0.55 T Judith Zimmermann1,2, Pan Su3, Lisa Wilmes1, Pedro Itriago Leon3, Marcel Dominik Nickel4, Wen Li1, Bonnie Joe1, and Nola Hylton1
1Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States, 2Radiology, Stanford University, Stanford, CA, United States, 3Siemens Medical Solutions, USA, Inc., Malvern, PA, United States, 4Siemens Healthineers AG, Erlangen, Germany Keywords: Breast, Low-Field MRI, Breast Motivation: With increasing availability and technical advances of low field 0.55T MRI systems, it is important to understand their value for breast applications. Goal(s): To present preliminary data of breast MRI at 0.55T with a newly available dedicated 7-channel prone breast coil. Approach: Breast MRI at 0.55T and 3T with NIST-calibrated breast phantom and two healthy female volunteers using protocols that are clinically relevant for breast cancer treatment monitoring. Results: Preliminary 0.55T breast MRI data has been successfully generated with acceptable image quality and will initiate future studies with breast cancer patients to advance breast MRI with low field systems. Impact: This first acquisition of
breast phantom and healthy volunteer data using sequences relevant in breast
cancer treatment monitoring (T1-weighted, T2-weighted, diffusion-weighted) will initiate further, more
detailed studies to explore the value of low field MRI for examining the
breast. |
| 08:27 | 0407.
 | Early Prediction of Treatment Response in HER2-Positive Breast Cancer Using multiparametric MRI Siyi Chen1, Wenjie Tang1, Yuan Guo1, Zhidan Zhong1, Yongzhou Xu2, Lu Han3, and Xinhua Wei1
1Department of Radiology, Guangzhou First People's Hospital, Guangzhou, China, 2Philips Healthcare, Guangzhou, China, 3Philips Healthcare, Shanghai, China Keywords: Breast, Tumor, multiparametric MRI, neoadjuvant chemotherapy (NAC), HER2-positive breast cancer Motivation: Imaging pre- and post- neoadjuvant chemotherapy (NAC) fails to adequately capture and quantify temporal heterogeneity and biological changes of tumors. Goal(s): To assess if longitudinal changes in multiparametric MRI can predict early response to neoadjuvant chemotherapy (NAC) in HER2-positive breast cancer and to establish quantitative models based on these features. Approach: Two predictive models were developed, one based on clinicopathologic features and another that combined clinicopathologic and MRI features. Results: The combined model performs optimally in all datasets. Changes observed in multiparametric MRI can predict early treatment responses in HER2-positive BC and assist in tailoring personalized treatment plans. Impact: The prediction model was simple and feasible, which was helpful for individualized treatment planning. |
| 08:39 | 0408.
 | Classification of Breast Edema on T2-weighted imaging for predicting sentinel lymph node metastasis and biological behavior in breast cancer Yunfeng Zhou1, Shijia Xie1, Mengxiao Liu2, and Zhe Hou1
1Yijishan Hospitial, Wuhu, China, 2MR Research Collaboration Team, Diagnostic Imaging, Siemens Healthineers Ltd, Shanghai, China, Shanghai, China Keywords: Breast, Breast Motivation: Predicting sentinel lymph node (SLN) metastasis and biological behavior in patients with early-stage breast cancer is important. Goal(s): To determine whether preoperative classification of breast edema can predict SLN metastasis and biological behavior in patients with early-stage breast cancer. Approach: Breast edema was scored on a scale of 1 to 4 on T2WI to explore additional predictive value of the breast edema score (BES) model. Results: The combined BES model significantly improved the predictive performance of SLN metastasis. Impact: Breast
edema on T2-weighted imaging can be used to predict SLN metastasis in breast
cancer, helping clinicians to develop individualized treatment plans and
evaluate prognosis.
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| 08:51 | 0409.
 | In vivo CEST-MRI Parameters correlate to Transcriptome and Metabolic Features in Breast Lesions Durga Udayakumar1, Xiaojing Wang1, Ling Cai2, Yin Xi1, Stephen Seiler1, Sunati Sahoo3, Ivan E Dimitrov4, Jochen Keupp5, and Elena Vinogradov1
1Radiology, UT Southwestern Medical Center, Dallas, TX, United States, 2Peter O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, TX, United States, 3Pathology, UT Southwestern Medical Center, Dallas, TX, United States, 4Philips Healthcare, Gainesville, FL, United States, 5Philips Research, Hamburg, Germany Keywords: Breast, Breast, CEST, Biomarkers, Cancer, Tissue Characterization Motivation: CEST-MRI could provide biochemical and molecular information on breast lesions before detection of physiological and anatomical changes. Goal(s): Our goal is to identify suitable in vivo CEST-MRI biomarker candidates. Approach: 12 patients with 6 benign and 8 malignant lesions (pathology confirmed) who had concurrent CEST-MRI, transcriptome, and metabolomic data were included. Results: Expression of several genes and metabolites correlated with MTRasym values (P<0.05) at 1, 2, and 3.5 ppm. At 1 and 2 ppm, DNA damage, cell cycle, stress response, and small molecule metabolic processes were prominently represented. Specific metabolites (e.g., Citrate/Isocitrate, glucuronate) showed significant correlations at 1, 2, and 3.5 ppm. Impact: In vivo CEST-MRI parameters are reflective of transcriptome and metabolomic features in breast lesions. This provides molecular information, potentially before the detection of physiological and anatomical changes, and could facilitate accurate prediction of response to therapy allowing earlier interventions. |
| 09:03 | 0410.
 | Identification of pretreatment habitat signatures for the prediction of patient outcome in triple negative breast cancer Anum Kazerouni1, Laura Kennedy2, Shaveta Vinayak1, Suzanne Dintzis1, Habib Rahbar1, and Savannah Partridge1
1University of Washigton, Seattle, WA, United States, 2Vanderbilt University, Nashville, TN, United States Keywords: Breast, Radiomics, habitat imaging Motivation: Triple negative breast cancer (TNBC) patients exhibit diverse response to therapy, with ~30% achieving pathological complete response (pCR). Goal(s): In this study, we seek to spatially-resolve heterogeneity of the tumor microenvironment using multiparametric MRI (mpMRI) in TNBC patients undergoing neoadjuvant chemotherapy to predict treatment outcomes. Approach: We employ habitat imaging, clustering mpMRI data to identify physiologically distinct tumor subregions, or habitats. Patients are then defined by tumor habitat composition and clustered to identify common habitat signatures. Associations between habitat signatures and patient outcomes are evaluated. Results: Clustering of patients yielded three habitat signatures with significantly different rates of pCR and recurrence-free survival. Impact: We demonstrate that tumor habitat signatures can differentiate triple-negative breast cancer patients prior to neoadjuvant chemotherapy, identifying those with improved treatment response and long-term outcomes. Clinical translation of this approach could enable patient stratification for therapy escalation/de-escalation and treatment optimization. |
| 09:15 | 0411.
 | Prospective performance of an MRI algorithm for early re-direction of breast cancer neoadjuvant treatment Natsuko Onishi1, Jesiica E Gibbs1, Wen Li1, Elissa R Price 1, Barbara LeStage2, William F Symmans3, Christina Yau4, John Kornak5, the I-SPY 2 Imaging Working Group, the I-SPY 2 Investigator Network6, Angela DeMichele7, Laura J Esserman4, and Nola M Hylton1
1Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States, 2I-SPY 2 Advocacy Group, San Francisco, CA, United States, 3Department of Pathology, MD Anderson Cancer Center, Houston, TX, United States, 4Department of Surgery, University of California, San Francisco, San Francisco, CA, United States, 5Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, United States, 6University of California, San Francisco, San Francisco, CA, United States, 7Department of Medical Oncology, University of Pennsylvania, Philadelphia, PA, United States Keywords: Breast, Cancer Motivation: In our preliminary study of breast cancer patients undergoing neoadjuvant treatment in the I-SPY 2 TRIAL, functional tumor volume (FTV)-based algorithm using 3-week and 6-week MRI successfully identified sub-optimal responders as potential candidates for early treatment re-direction. Goal(s): We aimed to evaluate the performance of the algorithm using data collected after the requirement for 6-week MRI based on 3-week response was officially added. Approach: We tested PPV and sensitivity of the algorithm in 146 patients enrolled in I-SPY 2 between October 2021 and June 2022. Results: The combined 3-week and 6-week MRI algorithm showed high PPV and high sensitivity in identifying sub-optimal responders. Impact: In the I-SPY 2 neoadjuvant breast cancer trial, an MRI-based algorithm demonstrated its ability to identify sub-optimal responders at 6 weeks of treatment. This will impact response-based personalization of treatment in future clinical trials and ultimately treatment in the clinic. |
| 09:27 | 0412.
 | Radiogenomics reveals tumor heterogeneity associated with the response to neoadjuvant chemotherapy in luminal breast cancer Shiyun Sun1, Chao You1, and Yajia Gu1
1Fudan University Shanghai Cancer Center, Shanghai, China Keywords: Breast, Breast, Luminal breast cancer, Radiomics, Magnetic resonance imaging (MRI), Tumor heterogeneity, Interpretability Motivation: There is an urgent clinical need to develop predictive biomarkers that can help identify proper candidates for neoadjuvant chemotherapy (NAC) in luminal breast cancer. Goal(s): To develop tailored prediction model for response to NAC, identify stable predictive features shared between Eastern and Western populations and reveal their biological interpretability. Approach: Multiscale radiomic features, multiple feature selection methods and classifiers, bioinformatics analysis, three independent cohorts. Results: The combination of "high-frequency features-XGBoost" demonstrated the best predictive performance for NAC response. Four multiscale radiomic features were identified as stable and discriminative predictive features between Eastern and Western populations, which associated with the immune-related and PPAR pathways. Impact: We proposed a more rigorous approach to ensure the
robustness of radiomic features and explored the stable predictive features and
their biological significance across different populations of luminal breast
cancer. It will capture the interest of radiologist and clinicians. |
| 09:39 | 0413.
 | Supine breast MRI with a wearable coil (BraCoil) improves lesion localization and clinical workflow for US-guided biopsy Raphaela Czerny1, Paola Clauser2, Michael Obermann1, Pascal A. T. Baltzer2, Elmar Laistler1, and Lena Nohava1
1High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria, 2Department of Biomedical Imaging and Image-guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Vienna, Austria Keywords: Breast, Visualization Motivation: Supine breast MRI might enable higher image correlation to supine ultrasound (US) and therefore facilitate the clinical workflow. Goal(s): The aim was to quantify lesion displacement between supine US, prone MRI, and supine MRI in Cartesian and panoramic views, and derive the impact on the clinical workflow. Approach: Using MRI and US patient data, the spatial lesion displacement was measured. For supine MRI a wearable breast coil (BraCoil) was used. Results: Supine MRI shows comparable lesion position compared to US, in contrast to prone MRI. 18% of the lesions could only be localized in 2nd look US or biopsy after supine BraCoil MRI. Impact: Supine breast MRI with a wearable coil could improve the clinical workflow by facilitating lesion localization for 2nd look US, biopsy, or surgery. |
| 09:51 | 0414.
 | NORMAL APPEARING BREAST TISSUE ON BREAST MRI HAS ALTERED CHEMISTRY CONSISTENT WITH “SWITCHED-ON” STATES IN WOMEN WITH INVASIVE CARCINOMA Carolyn Mountford1,2, Darren Lukas1,2, Natali Naude1, Jeremy Khoo3, Gorane Santamaria Hormaechea1,4, John Irvine1,2, Thomas Lloyd3, Ian Bennett3, David Clark5, Randell Brown6, Lisa Rich1, Laurie Kear1, and Peter Malycha1,7
1Griffith University, Southport, Australia, 2Datchem Pty Ltd, Brisbane, Australia, 3Princess Alexandra Hospital, Woolloongabba, Australia, 4Radiology, Princess Alexandra Hospital, Woolloongabba, Australia, 5The Breast Centre, Gateshead, Australia, 6Jones Radiology, Adelaide, Australia, 7Datchem, Brisbane, Australia Keywords: Breast, Spectroscopy, lipids, cholesterol Motivation: Adenoma-carcinoma cell models examined using 2D COSY recorded altered triglyceride, cholesterol and metabolites prior to malignant transformation. Goal(s): Investigate if such chemical profiles are recorded in vivo in MRI apparently normal tissue in women with invasive cancer. Approach: Nineteen women with invasive breast cancer were compared with healthy low risk controls. Results: Compared to controls, MRI normal tissue in cancer patients with low-density breasts recorded increases in cross peak F (68%), cholesterol (127%), and tumor promotor UDP-GlcNAc (81%). For dense breasts, increases recorded in cross peak F (47%), decreases in cholesterol (12%), triglyceride (56%) and double bonds (40%) in "switched-on" tissue. Impact: Altered chemistry states, consistent with mechanisms leading to development of invasive carcinoma, are recorded in vivo from breast tissue distant to the cancer compared to controls. These states are referred to as "switched-on" tissue and differ according to breast density. |
| 10:03 | 0415. | WITHDRAWN |