title: Estimating breast tumor blood flow during neoadjuvant chemotherapy using interleaved high temporal and high spatial resolution MRI.
abstract: OBJECTIVE
  To evaluate an interleaved MRI sampling strategy that acquires both high temporal resolution (HTR) dynamic contrast-enhanced (DCE) data for quantifying breast tumor blood flow (TBF) and high spatial resolution (HSR) DCE data for clinical reporting, following a single standard injection of contrast agent.
  
  
  METHODS
  A simulation study was used to evaluate the performance of the interleaved technique under different conditions. In a prospective clinical study, 18 patients with primary breast cancer, who were due to undergo neoadjuvant chemotherapy (NACT), were examined using interleaved HTR and HSR DCE-MRI at 1.5 Tesla. Tumor regions of interest were analyzed with a two-compartment tracer kinetic model. Paired parameters (n = 10) from the data acquired before and post-cycle 2 of NACT were compared using the nonparametric Wilcoxon signed-rank test.
  
  
  RESULTS
  Simulations demonstrated that TBF was reliably estimated using the proposed strategy. The region of interest analysis revealed significant changes in TBF (0.81-0.43 mL/min/mL; P = 0.002) following two cycles of NACT. The HSR data were reported in the normal way and enabled the assessment of tumor volume, which decreased by 53% following NACT (P = 0.065).
  
  
  CONCLUSIONS
  TBF can be measured reliably using the proposed strategy without compromising a standard clinical protocol. Furthermore, in our feasibility study, TBF decreased significantly following NACT, whereas capillary permeability surface-area product did not. Magn Reson Med 79:317-326, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
authors.affiliation: Division of Biomedical Imaging, University of Leeds, Leeds, United Kingdom.
authors.forename: Leonidas
authors.initials: L
authors.lastname: Georgiou
authors.affiliation: Department of Radiology, Leeds Teaching Hospital NHS Trust, Leeds, United Kingdom.
authors.forename: Nisha
authors.initials: N
authors.lastname: Sharma
authors.affiliation: Division of Biomedical Imaging, University of Leeds, Leeds, United Kingdom.|Department of Medical Physics and Engineering, Leeds Teaching Hospital NHS Trust, Leeds, United Kingdom.
authors.forename: David A
authors.identifier: http://orcid.org/0000-0002-5892-4762
authors.initials: DA
authors.lastname: Broadbent
authors.affiliation: Department of Medical Physics and Engineering, Leeds Teaching Hospital NHS Trust, Leeds, United Kingdom.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Wilson
authors.affiliation: Department of Radiology, Leeds Teaching Hospital NHS Trust, Leeds, United Kingdom.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Dall
authors.affiliation: Division of Biomedical Imaging, University of Leeds, Leeds, United Kingdom.|Western General Hospital, NHS Lothian, Edinburgh, United Kingdom.
authors.forename: Anmol
authors.initials: A
authors.lastname: Gangi
authors.affiliation: Division of Biomedical Imaging, University of Leeds, Leeds, United Kingdom.
authors.forename: David L
authors.initials: DL
authors.lastname: Buckley
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000188:drug therapy; D003198:Computer Simulation; D003287:Contrast Media; D003430:Cross-Sectional Studies; D003520:Cyclophosphamide / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D059629:Signal-To-Noise Ratio
chemical_list: D003287:Contrast Media; D015251:Epirubicin; D003520:Cyclophosphamide
keywords: DCE-MRI; breast; chemotherapy; high temporal resolution; tracer kinetic model; tumor blood flow