Paula Puerta González

arXiv2026

Neoadjuvant chemotherapy response prediction using pretreatment diffusion and contrast-enhanced magnetic resonance imaging with clinical variables

Prediction of pathological complete response before neoadjuvant chemotherapy may facilitate more tailored therapeutic planning for breast cancer patients. This work proposes a deep-learning model for pretreatment data only, combining apparent diffusion coefficient maps, dynamic contrast-enhanced magnetic resonance imaging, and clinical variables. The study uses the public ACRIN 6698/I-SPY2 multicenter dataset. The architecture employs EfficientNet-B0 pretrained encoders for image feature extraction and late fusion with clinical information. Multiple clinical variables were evaluated, including age, race, histological type, HR/HER2 subtype, SBR grade, and maximum diameter. Only HR/HER2 subtype improved the average area under the receiver operating characteristic curve (AUC) and was retained in the final model. Using stratified five-fold cross-validation, standalone apparent diffusion coefficient maps achieved a mean AUC of 0.79, whereas dynamic contrast-enhanced magnetic resonance imaging achieved 0.74. Adding HR/HER2 subtype improved performance to 0.83 and 0.81, respectively. The final configuration, using both imaging modalities and HR/HER2 subtype, achieved an AUC of 0.86. These results support pretreatment multimodal learning for response prediction, although external validation is required before clinical use.

cs.AI↗

arXiv2026

Early Prediction of Pathological Complete Response to Neoadjuvant Chemotherapy Using Temporal Deep Learning on DWI

Early identification of non-responders to neoadjuvant chemotherapy (NACT) is crucial for timely treatment adaptation in breast cancer. However, many existing predictive models rely on multiparametric magnetic resonance imaging (MRI), late treatment time points, or extensive clinical data, which limits their applicability. This study proposes a deep learning framework for early prediction of pathological complete response (pCR) using only diffusion-weighted MRI (DW-MRI) acquired at baseline and after the first NACT cycle. This framework feeds cropped tumor-centered patches to an EfficientNet-based temporal model that directly learns tumor shape and local tissue characteristics without explicit radiomic feature engineering. The model, trained with 10-fold cross-validation, achieved an area under the receiver operating characteristic curve (AUC) of 0.90 for pCR prediction after one cycle, providing actionable information after a single treatment cycle while avoiding gadolinium administration and reducing dependence on heterogeneous clinical data. By focusing on the baseline-to-first-cycle window instead of later stages, the approach supports earlier escalation or de-escalation of NACT, and its exclusive reliance on DW-MRI facilitates protocol standardization, multi-centre deployment and privacy-preserving data sharing. These results demonstrate that DW-MRI-based deep learning on tumor-centered patches constitutes a minimally invasive, clinically deployable strategy for early pCR prediction, with direct implications for personalized treatment adaptation in neoadjuvant breast cancer therapy.

cs.AI↗