FIGURE 8:

A 52-year-old woman with triple positive (ER, PR, and HER2+) high-grade invasive ductal carcinoma evaluated with breast MRI before and after four cycles neoadjuvant chemotherapy (a: first postcontrast subtraction, b: T₂-weighted). 3D whole lesion volume of interest (VOI) was annotated using a seed-growing semiautomated segmentation technique on subtraction images (c, red lesion) with peritumoral region (c, blue lesion) automatically generated based on VOI. Tumor and peritumoral VOIs were then propagated to coregistered T₂ images (c) and first-order texture features were analyzed. Lesions that demonstrated high T₂ whole lesion entropy, T₁ core lesion entropy, and T₂ peritumoral skewness and kurtosis were more likely to exhibit pathologic complete response (pCR; accuracy = 74%). The patient demonstrated complete imaging response on post-neoadjuvant therapy imaging (e,f) and had pCR at final surgical pathology. (Reprinted and adapted with permission from Heacock et al. RSNA 2017.)