MR Elastography for early prediction of neoadjuvant chemotherapy efficacy in breast cancer

Motivation: Currently, there is no reliable method to predict neoadjuvant chemotherapy (NACT) efficacy during treatment of breast cancer. Goal(s): This study evaluates MR Elastography (MRE) as a method for early prediction of response in breast cancer patients undergoing NACT by assessing tissue biomechanics. Approach: MRE was performed in 56 patients pre-NACT and post first cycle (1.1). By analyzing phase-angle (Y) and elasticity dynamics (ratio=pre-NACT /1.1). Results: We observed that partial-responders exhibit increased stiffness and decreased phase-angle, potentially caused by fibroblast-driven collagen deposition. MRE showed an improved ROC curve (AUC=0.913) using the Y-ratio (RC=5% cut-off) compared to clinical DCE-MRI at post-NACT (AUC=0.690). Impact: MRE has a strong predictive potential and offers a non-invasive method for early assessment of neoadjuvant chemotherapy efficacy in breast cancer using dynamic changes of the phase-angle determined at pre-treatment and after the first cycle of chemotherapy.