Lipid composition mapping for early response to neoadjuvant chemotherapy in breast cancer using chemical shift-encoded imaging

Motivation: Deregulation of lipid composition, holding a critical role in breast cancer progression, can be accurately mapped using chemical shift-encoded imaging (CSEI), and might support response monitoring in patients undergoing neoadjuvant chemotherapy (NACT). Goal(s): We aimed to determine the power of CSEI in differentiation of poor responders after one cycle of NACT. Approach: Seventeen patients were imaged before and after one cycle of NACT to compute the percentage change in monounsaturated, polyunsaturated and saturated fatty acids. Results: There was a treatment induced lipid normalisation in all participants, however there was no difference in poor responders in comparison to good responders. Impact: CSEI is sensitive to the longitudinal change in lipid composition in the peri-tumoural region and the whole breast, however the impact on lipid metabolism is secondary to determining poor responder and other markers of metabolic imaging should be explored.