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Zaric O, Farr A, Minarikova L, Lachner S, Asseryanis E, Nagel AM, Weber M, Singer CF, Trattnig S. Tissue Sodium Concentration Quantification at 7.0-T MRI as an Early Marker for Chemotherapy Response in Breast Cancer: A Feasibility Study. Radiology 2021; 299:63-72. [PMID: 33591888 DOI: 10.1148/radiol.2021201600] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background Tissue sodium concentration (TSC) is elevated in breast cancer and can determine chemotherapy response. Purpose To test the feasibility of using a sodium 23 (23Na) MRI protocol at 7.0 T for TSC quantification to predict early treatment outcomes of neoadjuvant chemotherapy in breast cancer and to determine whether those quantitative values provide additional information about efficacy. Materials and Methods Women with primary breast cancer were included in this prospective study. From July 2017 to June 2018, participants underwent 7.0-T 23Na MRI. Multichannel data sets were acquired with a density-adapted, three-dimensional radial projection reconstruction pulse sequence. Two-dimensional tumor size and TSC were evaluated before and after the first and second chemotherapy cycle, and statistical tests were performed based on the presence or absence of a pathologic complete response (pCR). Results Fifteen women with breast cancer and six healthy women were enrolled. The mean baseline tumor size in women with a pCR was 7.0 cm2 ± 5.0 (standard deviation), and the mean baseline tumor size in women without a pCR was 19.0 cm2 ± 12.0. After the first chemotherapy cycle, women with a pCR showed a reduced tumor size of 32.9% (2.3 cm2/7.0 cm2), compared with 15.3% (2.9 cm2/19.0 cm2) in those without a pCR. The areas under the receiver operating characteristic curve for tumor size reduction after the first and second chemotherapy cycle were 0.73 (95% CI: 0.09, 0.50; P = .12) and 0.93 (95% CI: 0.04, 0.60; P < .001), respectively. Women with a pCR had a mean baseline TSC of 69.4 mmol/L ± 6.1, with a reduction of 12.0% (8.3 mmol/L), whereas those without a pCR had a mean baseline TSC of 71.7 mmol/L ± 5.7, with a reduction of 4.7% (3.4 mmol/L) after the first cycle. The areas under the receiver operating characteristic curve for TSC after the first and second cycles were 0.96 (95% CI: 0.86, 1.00; P < .001) and 1.000 (95% CI: 1.00, P < .001), respectively. Conclusion Using 7.0-T MRI for tissue sodium concentration quantification to predict early treatment outcomes of neoadjuvant chemotherapy in breast cancer is feasible, with reduced tissue sodium concentration indicative of cancer response. © RSNA, 2021 Online supplemental material is available for this article.
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Affiliation(s)
- Olgica Zaric
- From the Institute for Clinical Molecular MRI in Musculoskeletal System, Karl Landsteiner Society, Vienna, Austria (O.Z., S.T.); Breast Health Center, Department of Obstetrics and Gynecology (A.F., E.A., C.F.S.), and High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy (L.M., M.W., S.T.), Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria; Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany (S.L., A.M.N.); and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
| | - Alex Farr
- From the Institute for Clinical Molecular MRI in Musculoskeletal System, Karl Landsteiner Society, Vienna, Austria (O.Z., S.T.); Breast Health Center, Department of Obstetrics and Gynecology (A.F., E.A., C.F.S.), and High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy (L.M., M.W., S.T.), Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria; Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany (S.L., A.M.N.); and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
| | - Lenka Minarikova
- From the Institute for Clinical Molecular MRI in Musculoskeletal System, Karl Landsteiner Society, Vienna, Austria (O.Z., S.T.); Breast Health Center, Department of Obstetrics and Gynecology (A.F., E.A., C.F.S.), and High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy (L.M., M.W., S.T.), Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria; Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany (S.L., A.M.N.); and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
| | - Sebastian Lachner
- From the Institute for Clinical Molecular MRI in Musculoskeletal System, Karl Landsteiner Society, Vienna, Austria (O.Z., S.T.); Breast Health Center, Department of Obstetrics and Gynecology (A.F., E.A., C.F.S.), and High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy (L.M., M.W., S.T.), Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria; Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany (S.L., A.M.N.); and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
| | - Ella Asseryanis
- From the Institute for Clinical Molecular MRI in Musculoskeletal System, Karl Landsteiner Society, Vienna, Austria (O.Z., S.T.); Breast Health Center, Department of Obstetrics and Gynecology (A.F., E.A., C.F.S.), and High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy (L.M., M.W., S.T.), Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria; Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany (S.L., A.M.N.); and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
| | - Armin M Nagel
- From the Institute for Clinical Molecular MRI in Musculoskeletal System, Karl Landsteiner Society, Vienna, Austria (O.Z., S.T.); Breast Health Center, Department of Obstetrics and Gynecology (A.F., E.A., C.F.S.), and High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy (L.M., M.W., S.T.), Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria; Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany (S.L., A.M.N.); and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
| | - Michael Weber
- From the Institute for Clinical Molecular MRI in Musculoskeletal System, Karl Landsteiner Society, Vienna, Austria (O.Z., S.T.); Breast Health Center, Department of Obstetrics and Gynecology (A.F., E.A., C.F.S.), and High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy (L.M., M.W., S.T.), Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria; Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany (S.L., A.M.N.); and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
| | - Christian F Singer
- From the Institute for Clinical Molecular MRI in Musculoskeletal System, Karl Landsteiner Society, Vienna, Austria (O.Z., S.T.); Breast Health Center, Department of Obstetrics and Gynecology (A.F., E.A., C.F.S.), and High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy (L.M., M.W., S.T.), Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria; Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany (S.L., A.M.N.); and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
| | - Siegfried Trattnig
- From the Institute for Clinical Molecular MRI in Musculoskeletal System, Karl Landsteiner Society, Vienna, Austria (O.Z., S.T.); Breast Health Center, Department of Obstetrics and Gynecology (A.F., E.A., C.F.S.), and High Field MR Center, Department of Biomedical Imaging and Image-guided Therapy (L.M., M.W., S.T.), Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria; Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany (S.L., A.M.N.); and Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria (S.T.)
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31
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Partridge SC, Zhang Z, Newitt DC, Gibbs JE, Chenevert TL, Rosen MA, Bolan PJ, Marques HS, Romanoff J, Cimino L, Joe BN, Umphrey HR, Ojeda-Fournier H, Dogan B, Oh K, Abe H, Drukteinis JS, Esserman LJ, Hylton NM. Diffusion-weighted MRI Findings Predict Pathologic Response in Neoadjuvant Treatment of Breast Cancer: The ACRIN 6698 Multicenter Trial. Radiology 2018; 289:618-627. [PMID: 30179110 PMCID: PMC6283325 DOI: 10.1148/radiol.2018180273] [Citation(s) in RCA: 156] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 07/12/2018] [Accepted: 07/18/2018] [Indexed: 01/06/2023]
Abstract
Purpose To determine if the change in tumor apparent diffusion coefficient (ADC) at diffusion-weighted (DW) MRI is predictive of pathologic complete response (pCR) to neoadjuvant chemotherapy for breast cancer. Materials and Methods In this prospective multicenter study, 272 consecutive women with breast cancer were enrolled at 10 institutions (from August 2012 to January 2015) and were randomized to treatment with 12 weekly doses of paclitaxel (with or without an experimental agent), followed by 12 weeks of treatment with four cycles of anthracycline. Each woman underwent breast DW MRI before treatment, at early treatment (3 weeks), at midtreatment (12 weeks), and after treatment. Percentage change in tumor ADC from that before treatment (ΔADC) was measured at each time point. Performance for predicting pCR was assessed by using the area under the receiver operating characteristic curve (AUC) for the overall cohort and according to tumor hormone receptor (HR)/human epidermal growth factor receptor 2 (HER2) disease subtype. Results The final analysis included 242 patients with evaluable serial imaging data, with a mean age of 48 years ± 10 (standard deviation); 99 patients had HR-positive (hereafter, HR+)/HER2-negative (hereafter, HER2-) disease, 77 patients had HR-/HER2- disease, 42 patients had HR+/HER2+ disease, and 24 patients had HR-/HER2+ disease. Eighty (33%) of 242 patients experienced pCR. Overall, ΔADC was moderately predictive of pCR at midtreatment/12 weeks (AUC = 0.60; 95% confidence interval [CI]: 0.52, 0.68; P = .017) and after treatment (AUC = 0.61; 95% CI: 0.52, 0.69; P = .013). Across the four disease subtypes, midtreatment ΔADC was predictive only for HR+/HER2- tumors (AUC = 0.76; 95% CI: 0.62, 0.89; P < .001). In a test subset, a model combining tumor subtype and midtreatment ΔADC improved predictive performance (AUC = 0.72; 95% CI: 0.61, 0.83) over ΔADC alone (AUC = 0.57; 95% CI: 0.44, 0.70; P = .032.). Conclusion After 12 weeks of therapy, change in breast tumor apparent diffusion coefficient at MRI predicts complete pathologic response to neoadjuvant chemotherapy. © RSNA, 2018 Online supplemental material is available for this article.
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Affiliation(s)
- Savannah C. Partridge
- From the Department of Radiology, University of Washington, 825
Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics
(Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown
University, Providence, RI; American College of Radiology Imaging Network
(ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical
Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N.,
J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of
Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of
Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for
Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn
(P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group,
Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham,
Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San
Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD
Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern
Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and
Science University, Portland, Ore (K.O.); Department of Radiology, University of
Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of
Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
| | - Zheng Zhang
- From the Department of Radiology, University of Washington, 825
Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics
(Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown
University, Providence, RI; American College of Radiology Imaging Network
(ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical
Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N.,
J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of
Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of
Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for
Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn
(P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group,
Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham,
Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San
Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD
Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern
Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and
Science University, Portland, Ore (K.O.); Department of Radiology, University of
Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of
Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
| | - David C. Newitt
- From the Department of Radiology, University of Washington, 825
Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics
(Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown
University, Providence, RI; American College of Radiology Imaging Network
(ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical
Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N.,
J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of
Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of
Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for
Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn
(P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group,
Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham,
Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San
Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD
Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern
Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and
Science University, Portland, Ore (K.O.); Department of Radiology, University of
Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of
Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
| | - Jessica E. Gibbs
- From the Department of Radiology, University of Washington, 825
Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics
(Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown
University, Providence, RI; American College of Radiology Imaging Network
(ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical
Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N.,
J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of
Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of
Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for
Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn
(P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group,
Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham,
Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San
Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD
Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern
Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and
Science University, Portland, Ore (K.O.); Department of Radiology, University of
Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of
Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
| | - Thomas L. Chenevert
- From the Department of Radiology, University of Washington, 825
Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics
(Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown
University, Providence, RI; American College of Radiology Imaging Network
(ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical
Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N.,
J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of
Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of
Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for
Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn
(P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group,
Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham,
Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San
Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD
Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern
Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and
Science University, Portland, Ore (K.O.); Department of Radiology, University of
Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of
Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
| | - Mark A. Rosen
- From the Department of Radiology, University of Washington, 825
Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics
(Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown
University, Providence, RI; American College of Radiology Imaging Network
(ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical
Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N.,
J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of
Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of
Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for
Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn
(P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group,
Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham,
Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San
Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD
Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern
Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and
Science University, Portland, Ore (K.O.); Department of Radiology, University of
Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of
Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
| | - Patrick J. Bolan
- From the Department of Radiology, University of Washington, 825
Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics
(Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown
University, Providence, RI; American College of Radiology Imaging Network
(ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical
Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N.,
J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of
Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of
Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for
Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn
(P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group,
Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham,
Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San
Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD
Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern
Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and
Science University, Portland, Ore (K.O.); Department of Radiology, University of
Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of
Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
| | - Helga S. Marques
- From the Department of Radiology, University of Washington, 825
Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics
(Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown
University, Providence, RI; American College of Radiology Imaging Network
(ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical
Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N.,
J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of
Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of
Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for
Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn
(P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group,
Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham,
Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San
Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD
Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern
Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and
Science University, Portland, Ore (K.O.); Department of Radiology, University of
Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of
Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
| | - Justin Romanoff
- From the Department of Radiology, University of Washington, 825
Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics
(Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown
University, Providence, RI; American College of Radiology Imaging Network
(ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical
Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N.,
J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of
Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of
Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for
Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn
(P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group,
Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham,
Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San
Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD
Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern
Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and
Science University, Portland, Ore (K.O.); Department of Radiology, University of
Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of
Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
| | - Lisa Cimino
- From the Department of Radiology, University of Washington, 825
Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics
(Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown
University, Providence, RI; American College of Radiology Imaging Network
(ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical
Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N.,
J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of
Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of
Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for
Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn
(P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group,
Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham,
Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San
Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD
Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern
Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and
Science University, Portland, Ore (K.O.); Department of Radiology, University of
Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of
Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
| | - Bonnie N. Joe
- From the Department of Radiology, University of Washington, 825
Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics
(Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown
University, Providence, RI; American College of Radiology Imaging Network
(ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical
Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N.,
J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of
Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of
Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for
Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn
(P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group,
Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham,
Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San
Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD
Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern
Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and
Science University, Portland, Ore (K.O.); Department of Radiology, University of
Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of
Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
| | - Heidi R. Umphrey
- From the Department of Radiology, University of Washington, 825
Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics
(Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown
University, Providence, RI; American College of Radiology Imaging Network
(ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical
Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N.,
J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of
Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of
Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for
Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn
(P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group,
Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham,
Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San
Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD
Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern
Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and
Science University, Portland, Ore (K.O.); Department of Radiology, University of
Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of
Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
| | - Haydee Ojeda-Fournier
- From the Department of Radiology, University of Washington, 825
Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics
(Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown
University, Providence, RI; American College of Radiology Imaging Network
(ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical
Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N.,
J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of
Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of
Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for
Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn
(P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group,
Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham,
Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San
Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD
Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern
Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and
Science University, Portland, Ore (K.O.); Department of Radiology, University of
Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of
Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
| | - Basak Dogan
- From the Department of Radiology, University of Washington, 825
Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics
(Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown
University, Providence, RI; American College of Radiology Imaging Network
(ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical
Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N.,
J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of
Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of
Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for
Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn
(P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group,
Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham,
Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San
Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD
Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern
Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and
Science University, Portland, Ore (K.O.); Department of Radiology, University of
Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of
Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
| | - Karen Oh
- From the Department of Radiology, University of Washington, 825
Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics
(Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown
University, Providence, RI; American College of Radiology Imaging Network
(ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical
Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N.,
J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of
Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of
Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for
Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn
(P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group,
Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham,
Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San
Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD
Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern
Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and
Science University, Portland, Ore (K.O.); Department of Radiology, University of
Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of
Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
| | - Hiroyuki Abe
- From the Department of Radiology, University of Washington, 825
Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics
(Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown
University, Providence, RI; American College of Radiology Imaging Network
(ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical
Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N.,
J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of
Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of
Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for
Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn
(P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group,
Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham,
Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San
Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD
Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern
Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and
Science University, Portland, Ore (K.O.); Department of Radiology, University of
Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of
Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
| | - Jennifer S. Drukteinis
- From the Department of Radiology, University of Washington, 825
Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics
(Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown
University, Providence, RI; American College of Radiology Imaging Network
(ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical
Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N.,
J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of
Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of
Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for
Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn
(P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group,
Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham,
Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San
Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD
Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern
Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and
Science University, Portland, Ore (K.O.); Department of Radiology, University of
Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of
Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
| | - Laura J. Esserman
- From the Department of Radiology, University of Washington, 825
Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics
(Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown
University, Providence, RI; American College of Radiology Imaging Network
(ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical
Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N.,
J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of
Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of
Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for
Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn
(P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group,
Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham,
Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San
Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD
Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern
Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and
Science University, Portland, Ore (K.O.); Department of Radiology, University of
Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of
Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
| | - Nola M. Hylton
- From the Department of Radiology, University of Washington, 825
Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics
(Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown
University, Providence, RI; American College of Radiology Imaging Network
(ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical
Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N.,
J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of
Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of
Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for
Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn
(P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group,
Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham,
Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San
Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD
Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern
Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and
Science University, Portland, Ore (K.O.); Department of Radiology, University of
Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of
Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
| | - For the ACRIN 6698 Trial Team and I-SPY 2 Trial Investigators
- From the Department of Radiology, University of Washington, 825
Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics
(Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown
University, Providence, RI; American College of Radiology Imaging Network
(ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical
Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N.,
J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of
Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of
Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for
Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn
(P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group,
Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham,
Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San
Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD
Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern
Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and
Science University, Portland, Ore (K.O.); Department of Radiology, University of
Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee
Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of
Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
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