Blood oxygenation level-dependent (BOLD) contrast magnetic resonance imaging (MRI) for prediction of breast cancer chemotherapy response: A pilot study

Purpose: To determine whether a simple noninvasive method of assessing tumor oxygenation is feasible in the clinical setting and can provide useful, potentially predictive information. Tumor microcirculation and oxygenation play critical roles in tumor growth and responsiveness to cytotoxic treatment and may provide prognostic indicators for cancer therapy. Deoxyhemoglobin is paramagnetic and can serve as an endogenous contrast agent causing signal loss in echo planar magnetic resonance imaging (MRI) (blood oxygenation level‐dependent [BOLD]‐MRI). We used BOLD‐MRI to provide early evaluation of response to neoadjuvant chemotherapy in patients with locally advanced breast cancer. Materials and Methods: MRI was performed on 11 patients with biopsy‐proven malignancy. MRI exams were scheduled before, during, and after chemotherapy. The BOLD study applied a 6‐minute oxygen breathing challenge. Results: Seven patients successfully completed the exams. Before chemotherapy, BOLD contrast enhancement was observed in all tumors, but the patients, who ultimately had complete pathological response, exhibited a significantly higher BOLD response to oxygen breathing. Conclusion: We have successfully implemented an oxygen‐breathing challenge BOLD contrast technique as part of the standard breast MRI exam in patients with locally advanced breast cancer. The preliminary observation that a large BOLD response correlated with better treatment response suggests a predictive capability for BOLD MRI. J. Magn. Reson. Imaging 2013;37:1083–1092. © 2012 Wiley Periodicals, Inc.