MRI Identifies Which Breast Cancer Patients Need Hormonal Treatment or Chemotherapy

A new way to analyze MRI data has been discovered that distinguishes between breast cancer patients who need hormonal treatment or chemotherapy.

This new analysis could provide faster tests and lower costs for women with estrogen positive-receptor (ER-positive) breast cancer. The study was conducted by researchers at the Case Comprehensive Cancer Center and published in the Nature Scientific Reports journal.

"Until about 15 years ago, doctors had no way of telling aggressive cancer from non-aggressive, so the majority of women got chemotherapy, which can produce very harsh side effects," said lead researcher Anant Madabhushi.

There are nearly 70% of breast cancer patients who are ER-positive in the United States not in need of chemotherapy.

In order to address this issue, patients were issued a genomic test to determine aggressive cancers from nonaggressive cancers. Biopsy samples are collected from patients and sent to a company for analysis to compute a risk score that helps guide treatment decisions.

"The test is used frequently in the United States, but it destroys tissue, requires shipping and costs about $4000," Madabhushi said. "The cost puts the test out of reach for people in middle- and low-income countries."

During the study, researchers mined and analyzed radiologic data from the MRIs of 96 ER-positive patients at hospitals in Cleveland and Boston.

Researchers were able to see a differences in gene expression during testing, therefore, they converted the dynamic textural patterns into quantitative measurements. By using these differences in measurements, the researchers were able to determine which patients need chemotherapy or just a hormonal treatment instead.

"We think the dynamic texture data is robust and reliable," Madabhushi said. "It allows us to compare apples to apples."

Researchers believe that this new test would cost very little compared an MRI scan, which is something that is required by many doctors upon initial diagnosis and can cost thousands of dollars.

With this program, patients could receive their test results in minutes, instead of waiting for biopsy results to come back in a week or more.

"With cloud computing and data warehousing, we can analyze images coming in from anywhere in the world, "Madabhushi said. “It breaks down geographic boundaries because everything is electronically transmitted."

In order to look at the outcomes of the 96 study patients and to determine how accurate the test is, researchers are seeking deeper funding sources to test scans from more sites to see if the results hold up.

Even if the test proves to be accurate for patients with an extremely low or high need for chemotherapy, it would still be able to help approximately 30% to 40% of cancer patients.