Motivation: Variability in imaging protocols can reduce the predictive accuracy of biomarkers like FTV in multicenter trials. This study evaluates whether stricter DCE-MRI protocol adherence improves FTV's predictive power for pCR. Goal(s): To assess the impact of revised DCE-MRI protocols on FTV's accuracy for pCR in the I-SPY 2 trial. Approach: MRI data from 2,118 participants were analyzed, comparing AUCs for pCR prediction pre- and post-2021 protocol update, with acquisition duration consistency assessed via CV. Results: Post-update, AUC for FTV increased from 0.686 to 0.742, with acquisition CV consistently below 10%, indicating stable imaging conditions and enhanced predictive reliability. Impact: Enforcing stricter adherence to MRI protocol improved FTV's predictive accuracy for identifying pathological complete response (pCR) in breast cancer neoadjuvant therapy, increasing reliability and data consistency within the I-SPY 2 trial's multicenter framework.
Metanat et al. (Tue,) studied this question.