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Tomography
Volume 6
Issue 2
10.18383/j.tom.2020.00009
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Tomography is published by MDPI from Volume 7 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Grapho, LLC.
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Article

Comparison of Segmentation Methods in Assessing Background Parenchymal Enhancement as a Biomarker for Response to Neoadjuvant Therapy

by
Alex Anh-Tu Nguyen
1,
Vignesh A. Arasu
1,2,
Fredrik Strand
3,
Wen Li
1,
Natsuko Onishi
1,
Jessica Gibbs
1,
Ella F. Jones
1,
Bonnie N. Joe
1,
Laura J. Esserman
4,
David C. Newitt
1 and
Nola M. Hylton
1,*
1
Department of Radiology and Biomedical Imaging, University of California, 1600 Divisadero St. Room C255, San Francisco, CA 94115, USA
2
Department of Radiology, Kaiser Permanente Medical Center, Vallejo, CA, USA
3
Department of Oncology and Pathology, Karolinska Institute, Stockholm, Sweden
4
Department of Surgery, University of California, San Francisco, CA, USA
*
Author to whom correspondence should be addressed.
Tomography 2020, 6(2), 101-110; https://doi.org/10.18383/j.tom.2020.00009
Submission received: 5 March 2020 / Revised: 4 April 2020 / Accepted: 2 May 2020 / Published: 1 June 2020
Versions Notes

Abstract

Breast parenchymal enhancement (BPE) has shown association with breast cancer risk and response to neoadjuvant treatment. However, BPE quantification is challenging, and there is no standardized segmentation method for measurement. We investigated the use of a fully automated breast fibroglandular tissue segmentation method to calculate BPE from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for use as a predictor of pathologic complete response (pCR) following neoadjuvant treatment in the I-SPY 2 TRIAL. In this trial, patients had DCE-MRI at baseline (T0), after 3 weeks of treatment (T1), after 12 weeks of treatment and between drug regimens (T2), and after completion of treatment (T3). A retrospective analysis of 2 cohorts was performed: one with 735 patients and another with a final cohort of 340 patients, meeting a high-quality benchmark for segmentation. We evaluated 3 subvolumes of interest segmented from bilateral T1-weighted axial breast DCE-MRI: full stack (all axial slices), half stack (center 50% of slices), and center 5 slices. The differences between methods were assessed, and a univariate logistic regression model was implemented to determine the predictive performance of each segmentation method. The results showed that the half stack method provided the best compromise between sampling error from too little tissue and inclusion of incorrectly segmented tissues from extreme superior and inferior regions. Our results indicate that BPE calculated using the half stack segmentation approach has potential as an early biomarker for response to treatment in the hormone receptor–negative and human epidermal growth factor receptor 2–positive subtype.
Keywords: magnetic resonance imaging (MRI); neoadjuvant chemotherapy; background parenchymal enhancement (BPE); breast cancer; segmentation magnetic resonance imaging (MRI); neoadjuvant chemotherapy; background parenchymal enhancement (BPE); breast cancer; segmentation

Share and Cite

MDPI and ACS Style

Nguyen, A.A.-T.; Arasu, V.A.; Strand, F.; Li, W.; Onishi, N.; Gibbs, J.; Jones, E.F.; Joe, B.N.; Esserman, L.J.; Newitt, D.C.; et al. Comparison of Segmentation Methods in Assessing Background Parenchymal Enhancement as a Biomarker for Response to Neoadjuvant Therapy. Tomography 2020, 6, 101-110. https://doi.org/10.18383/j.tom.2020.00009

AMA Style

Nguyen AA-T, Arasu VA, Strand F, Li W, Onishi N, Gibbs J, Jones EF, Joe BN, Esserman LJ, Newitt DC, et al. Comparison of Segmentation Methods in Assessing Background Parenchymal Enhancement as a Biomarker for Response to Neoadjuvant Therapy. Tomography. 2020; 6(2):101-110. https://doi.org/10.18383/j.tom.2020.00009

Chicago/Turabian Style

Nguyen, Alex Anh-Tu, Vignesh A. Arasu, Fredrik Strand, Wen Li, Natsuko Onishi, Jessica Gibbs, Ella F. Jones, Bonnie N. Joe, Laura J. Esserman, David C. Newitt, and et al. 2020. "Comparison of Segmentation Methods in Assessing Background Parenchymal Enhancement as a Biomarker for Response to Neoadjuvant Therapy" Tomography 6, no. 2: 101-110. https://doi.org/10.18383/j.tom.2020.00009

APA Style

Nguyen, A. A. -T., Arasu, V. A., Strand, F., Li, W., Onishi, N., Gibbs, J., Jones, E. F., Joe, B. N., Esserman, L. J., Newitt, D. C., & Hylton, N. M. (2020). Comparison of Segmentation Methods in Assessing Background Parenchymal Enhancement as a Biomarker for Response to Neoadjuvant Therapy. Tomography, 6(2), 101-110. https://doi.org/10.18383/j.tom.2020.00009

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