Neoadjuvant chemotherapy (NAC), standard of care for invasive breast cancer, allows non-invasive monitoring of treatment progress with longitudinal MRI scans. Quantitative MRI metrics are needed to accurately predict treatment outcome both for de-escalation of treatment for good responders and for treatment switching for poor responders. The purpose of this challenge will be to compare predictive metrics for pCR derived from MRI diffusion weighted imaging (DWI), alone or in combination with dynamic-contrast-enhanced MRI (DCE).
The image data set for the challenge will be a subset of MRI studies from the ACRIN 6698 Trial ("6698"), a sub-study of the I-SPY 2 TRIAL designed to investigate the use of DWI for breast cancer NAC treatment response monitoring. Data will be available through The Cancer Imaging Archive (TCIA). Subjects in 6698 had longitudinal MRI studies, including standardized DWI and DCE scans, at four time points during NAC: T0 (pre-NAC), T1 (3 weeks NAC), T2 (12 weeks NAC) and T3 (pre-Surgery). T0-T2 will be used in the challenge. In addition to the original DWI and DCE image data, the DWI whole-tumor manual segmentations and DCE functional tumor volume segmentations utilized in the 6698 primary analysis will be provided to challenge participants. Use of the provided segmentations in challenge submissions optional. The patient cohort will be divided into training and test sub-groups, and candidate metrics may be either simple metrics (untrained), or models trained on the training sub-group. Each candidate metric submitted will be evaluated by the statistics group to determine its AUC for prediction of pCR in the test sub-group.
As a secondary aim, repeatability of the DWI measures will be evaluated in a 71 patient sub-group with "coffee-break' style test/retest DWI acquisitions. Within-subject coefficient of variance (wCV) will be evaluated and compared to reference values found for whole-tumor mean ADC from the ACRIN 6698 published analysis.
Each submission shall consist of a single compressed file consisting of two or three component files:
1) A comma-delimited (.csv) results file (BMMR2_<metric name>.csv) with two columns:
2) A descriptive file (*.csv or *.xlsx) (BMMR2_<metric name>_desc.<ext.>) including:
i. DCE maps or FTV segmentations
ii. DWI derived TRACE images or ADC maps
iii. DWI manual whole-tumor segmentations
3) A .csv test/retest results file (BMMR2_<metric name>_TRT.csv) with three columns:
The 3rd file may be omitted if DWI test/retest repeatability is not applicable to the metric. e.g., if the metric uses only DCE parameters.
Please do include this file in submissions even if it is identical across multiple ones, e.g., for a metric submitted for both the early-treatment T1 timepoint and the T2 timepoint.
Training phase: Research teams may submit any number of submissions to the MedICI challenge hosting site.
Test phase: Research teams may submit up to 10 individual metrics for consideration in the challenge. No re-submission will be allowed during this phase.
1) Metrics may be of any type but must produce a scalar numeric value for each patient that is to be tested for predictive power for pCR. For example, Mean ADC at T0 and Mean ADC at T1 would be 2 separate metrics.
2) Values must be provided for all patients in the appropriate cohort (Training or Test) and for both first and second DWI acquisitions in the n=71 test/retest cohort.
3) Metric calculations may use any combination of the provided T2w, DWI and DCE image acquisitions and the associated clinical data, including tumor subtype.
4) For definitiveness in the AUC calculations, please adjust the overall sign of all metrics so higher metric values indicate greater predicted likelihood of pCR.
By participating in this challenge, each participant agrees to:
Results of this challenge will be broadly relevant to the use of DWI for breast cancer treatment response assessment. In particular, they should be applicable to improving patient treatment decisions in breast cancer neoadjuvant clinical trials.
Start: May 28, 2021, 11 p.m.
Start: July 1, 2021, midnight
Nov. 30, 2021, 11:59 p.m.
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