Features of MRI stromal enhancement with neoadjuvant chemotherapy: A subgroup analysis of the ACRIN 6657/I-SPY TRIAL

Adam Olshen, Denise Wolf, Ella F. Jones, David Newitt, Laura Vant Veer, Christina Yau, Laura Esserman, Julia D. Wulfkuhle, Rosa I. Gallagher, Lisa Singer, Emanuel F. Petricoin, Nola Hylton, Catherine C. Park*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Although the role of cancer-activated stroma in malignant progression has been well investigated, the influence of an activated stroma in therapy response is not well understood. Using retrospective pilot cohorts, we previously observed that MRI detected stromal contrast enhancement was associated with proximity to the tumor and was predictive for relapse-free survival in patients with breast cancer receiving neoadjuvant chemotherapy. Here, to evaluate the association of stromal contrast enhancement to therapy, we applied an advanced tissue mapping technique to evaluate stromal enhancement patterns within 71 patients enrolled in the I-SPY 1 neoadjuvant breast cancer trial. We correlated MR stromal measurements with stromal protein levels involved in tumor progression processes. We found that stromal percent enhancement values decrease with distance from the tumor edge with the estimated mean change ranging .0.48 to .0.17 (P≤0.001) for time points T2 through T4. While not statistically significant, we found a decreasing trend in global stromal signal enhancement ratio values with the use of chemotherapy. There were no statistically significant differences between MR enhancement measurements and stromal protein levels. Findings from this study indicate that stromal features characterized by MRI are impacted by chemotherapy and may have predictive value in a larger study.

Original languageEnglish
Article number011014
JournalJournal of Medical Imaging
Issue number1
StatePublished - 1 Jan 2018
Externally publishedYes


  • MRI
  • breast cancer
  • enhancement
  • neoadjuvant
  • stroma


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