DPU - Symposium 2022

Medica l Image Ana lysis & Ar t i f icia l Intel l igence Symposium 2022 Nr. 14: Prof. DDr. Ramona Woitek: Hyperpolarised carbon-13 MRI allows early response assessment in patients with breast cancer undergoing neoadjuvant treatment Curriculum Vitae: Ramona Woitek completed her medical studies at the Medical University of Vienna in 2008, followed by a PhD in Clinical Neuroscience and a radiology residency at the Department of Biomedical Imaging and Image-guided Therapy at the Medical University of Vienna. Between 2017 and 2022, Univ.-Prof. Ramona Woitek worked scientifically and clinically at the Department of Radiology at the University of Cambridge and Addenbrookes Hospital in Cambridge, UK, where she researched hyperpolarised carbon-13 MRI and radiomics and multiomics in breast and ovarian cancer. Abstract: Hyperpolarised carbon-13 MRI allows early response assessment in patients with breast cancer undergoing neoadjuvant treatment Hyperpolarised carbon-13 MRI is a novel tool for probing tumour metabolism by measuring 13C-label exchange between intravenously injected hyperpolarised [1-13C]pyruvate and tissue lactate. Our study in patients with breast cancer demonstrates that hyperpolarised carbon-13 MRI can be used to detect very early response to neoadjuvant therapy. Eleven patients underwent multiparametric proton MRI and hyperpolarised carbon-13 MRI before and 7-11 days after commencing treatment. An increase in the lactate-to-pyruvate ratio of approximately 20% identified three patients who, following 5-6 cycles of treatment, showed pathological complete response. Carbon-13 MRI was superior in distinguishing patients with eventual pathological complete and non-complete response when compared to advanced proton MRI including dynamic contrast-enhanced MRI with pharmacokinetic modelling and diffusion-weighted MRI. Hyperpolarised carbon-13 MRI is therefore a promising method for monitoring very early treatment response in breast cancer and has demonstrated prognostic potential.

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