{"doi":"10.1148/rycan.220022","title":"Pretherapy Ferumoxytol-enhanced MRI to Predict Response to Liposomal Irinotecan in Metastatic Breast Cancer","abstract":"Purpose To investigate ferumoxytol (FMX)-enhanced MRI as a pretreatment predictor of response to liposomal irinotecan (nal-IRI) for thoracoabdominal and brain metastases in women with metastatic breast cancer (mBC). Materials and Methods In this phase 1 expansion trial (ClinicalTrials.gov identifier, NCT01770353; 27 participants), 49 thoracoabdominal (19 participants; mean age, 48 years ± 11 [SD]) and 19 brain (seven participants; mean age, 54 years ± 8) metastases were analyzed on MR images acquired before, 1–4 hours after, and 16–24 hours after FMX administration. In thoracoabdominal metastases, tumor transverse relaxation rate (R*2) was normalized to the mean R*2 in the spleen (rR*2), and the tumor histogram metric rR*2,N, representing the average of rR*2 in voxels above the nth percentile, was computed. In brain metastases, a novel compartmentation index was derived by applying the MRI signal equation to phantom-calibrated coregistered FMX-enhanced MRI brain scans acquired before, 1–4 hours after, and 16–24 hours after FMX administration. The fraction of voxels with an FMX compartmentation index greater than 1 was computed over the whole tumor (FCIGT1) and from voxels above the 90th percentile R*2 (FCIGT1 R*2,90). Results rR*2,90 computed from pretherapy MRI performed 16–24 hours after FMX administration, without reference to calibration phantoms, predicted response to nal-IRI in thoracoabdominal metastases (accuracy, 74%). rR*2,90 performance was robust to the inclusion of some peritumoral tissue within the tumor region of interest. FCIGT1 R*2,90 provided 79% accuracy on cross-validation in prediction of response in brain metastases. Conclusion This first in-human study focused on mBC suggests that FMX-enhanced MRI biologic markers can be useful for pretherapy prediction of response to nal-IRI in patients with mBC. Keywords: MRI Contrast Agent, MRI, Breast, Head/Neck, Tumor Response, Experimental Investigations, Brain/Brain Stem Clinical trial registration no. NCT01770353 Supplemental material is available for this article. © RSNA, 2023 See also commentary by Daldrup-Link in this issue.","journal":"Radiology Imaging Cancer","year":2023,"id":349092,"datarank":0.7117136543208532,"base_score":2.3978952727983707,"endowment":2.3978952727983707,"self_citation_contribution":0.3596842909197557,"citation_network_contribution":0.35202936340109753,"self_endowment_contribution":0.3596842909197557,"citer_contribution":0.35202936340109753,"corpus_percentile":null,"corpus_rank":null,"citation_count":10,"citer_count":10,"citers_with_citation_signal":7,"citers_with_endowment":7,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7954,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT01770353"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1092266,"name":"Andres Arias","orcid":"0000-0003-0239-1060","position":1,"is_corresponding":false},{"id":574411,"name":"James Costello","orcid":"0000-0003-0651-8129","position":2,"is_corresponding":false},{"id":242412,"name":"Hyo S. Han","orcid":"0000-0002-0072-0257","position":3,"is_corresponding":false},{"id":332437,"name":"Daniel Jeong","orcid":"0000-0003-4510-5204","position":4,"is_corresponding":false},{"id":1092267,"name":"Stephan G. Klinz","orcid":"0000-0001-7354-3346","position":5,"is_corresponding":false},{"id":107727,"name":"Jasgit C. Sachdev","orcid":"0000-0002-4408-7617","position":6,"is_corresponding":false},{"id":503499,"name":"Ronald L. Korn","orcid":"0000-0003-1141-5749","position":7,"is_corresponding":false},{"id":503500,"name":"Natarajan Raghunand","orcid":"0000-0002-8893-7687","position":8,"is_corresponding":false},{"id":503495,"name":"Harshan Ravi","orcid":"0000-0003-4118-4240","position":0,"is_corresponding":true}],"reference_count":41,"raw_metadata":null,"created_at":"2026-07-19T01:12:14.919810Z","pmid":"36734848","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}