Skip to main content

ORIGINAL RESEARCH article

Front. Oncol.
Sec. Cancer Imaging and Image-directed Interventions
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1356173
This article is part of the Research Topic Breast Cancer Imaging: Clinical Translation of Novel Methods View all 7 articles

The relationship between parameters measured using intravoxel incoherent motion and dynamic contrast-enhanced MRI in patients with breast cancer undergoing neoadjuvant chemotherapy: a longitudinal cohort study

Provisionally accepted
Zyad M. Almutlaq Zyad M. Almutlaq 1,2*Sarah E. Bacon Sarah E. Bacon 3Daniel J. Wilson Daniel J. Wilson 3Nisha Sharma Nisha Sharma 4Tatendashe Dondo Tatendashe Dondo 5David L. Buckley David L. Buckley 1
  • 1 Biomedical Imaging, Leeds Institute of Cardiovascular And Metabolic Medicine, Leeds, United Kingdom
  • 2 College of Applied Medical Science, King Saud bin Abdulaziz University for Health Science, Riyadh, Riyadh, Saudi Arabia
  • 3 Department of Medical Physics & Engineering, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
  • 4 Department of Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
  • 5 Clinical and Population Sciences Department, Leeds Institute of Cardiovascular And Metabolic Medicine, Leeds, United Kingdom

The final, formatted version of the article will be published soon.

    The primary aim of this study was to explore whether intravoxel incoherent motion (IVIM) can offer a contrast-agent-free alternative to dynamic contrast-enhanced (DCE)-MRI for measuring breast tumor perfusion. The secondary aim was to investigate the relationship between tissue diffusion measures from DWI and DCE-MRI measures of the tissue interstitial and extracellular volume fractions.A total of 108 paired DWI and DCE-MRI scans were acquired at 1.5 T from 40 patients with primary breast cancer (median age: 44.5 years) before and during neoadjuvant chemotherapy (NACT). DWI parameters included apparent diffusion coefficient (ADC), tissue diffusion (Dt), pseudo-diffusion coefficient (Dp), perfused fraction (f), and the product f×Dp (microvascular blood flow). DCE-MRI parameters included blood flow (Fb), blood volume fraction (vb), interstitial volume fraction (ve) and extracellular volume fraction (vd). All were extracted from three tumor regions of interest (whole-tumor, ADC cold-spot, and DCE-MRI hot-spot) at three MRI visits: pre-treatment, after one, and three cycles of NACT. Spearman's rank correlation was used for assessing between-subject correlations (r), while repeated measures correlation was employed to assess within-subject correlations (rrm) across visits between DWI and DCE-MRI parameters in each region.No statistically significant between-subject or within-subject correlation was found between the perfusion parameters estimated by IVIM and DCE-MRI (f versus vb and f×Dp versus Fb; P=0.07-0.81). Significant moderate positive between-subject and within-subject correlations were observed between ADC and ve (r=0.461, rrm=0.597) and between Dt and ve (r=0.405, rrm=0.514) as well as moderate positive within-subject correlations between ADC and vd and between Dt and vd (rrm=0.619 and 0.564, respectively) in the whole-tumor region.No correlations were observed between the perfusion parameters estimated by IVIM and DCE-MRI. This may be attributed to imprecise estimates of fxDp and vb, or an underlying difference in what IVIM and DCE-MRI measure. Care should be taken when interpreting the IVIM parameters (f and f×Dp) as surrogates for those measured using DCE-MRI. However, the moderate positive correlations found between ADC and Dt and the DCE-MRI parameters ve and vd confirms the expectation that as the interstitial and extracellular volume fractions increase, water diffusion increases.

    Keywords: Breast cancer1, intravoxel incoherent motion2, dynamic contrast enhanced MRI3, Perfusion4, repeated measures5, correlations6

    Received: 15 Dec 2023; Accepted: 07 May 2024.

    Copyright: © 2024 Almutlaq, Bacon, Wilson, Sharma, Dondo and Buckley. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Zyad M. Almutlaq, Biomedical Imaging, Leeds Institute of Cardiovascular And Metabolic Medicine, Leeds, United Kingdom

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.