Abstract

Pathologic complete response (pCR) is an important endpoint in neoadjuvant chemotherapy (NAC) for breast cancer, and predicting pCR from imaging during treatment could support treatment response assessment. Many existing imaging-based approaches rely on a single static timepoint, which fails to capture changes that occur during treatment. In this work, we present a longitudinal framework that combines a frozen 3D foundation encoder (Pillar-0) with our Temporal Dynamics Network (TDN) to predict treatment response from serial Dynamic Contrast-Enhanced (DCE) MRI acquired across four clinical timepoints from pre-treatment to pre-surgery. The TDN combines time-aware volumetric embeddings with clinical and treatment data to predict pCR. Evaluated on 982 patients from the combined I-SPY2 and ACRIN-6698 cohort, the proposed model achieves strong performance across all reported metrics when longitudinal 3D imaging is fused with clinical data (test AUROC: 73.6%, balanced accuracy: 69.1%). While clinical variables provide the strongest individual predictive signal, longitudinal 3D imaging contributes complementary information when fused with clinical data, improving pCR prediction. Our source code is available at: https://github.com/omarftt/longitudinal_temporal_pillar.

Links to Paper and Supplementary Materials

Main Paper (Open Access Version): https://papers.miccai.org/miccai-2026-sat/paper/AMAI_012.pdf

SharedIt Link: Not yet available

SpringerLink (DOI): Not yet available

Supplementary Material: Not Submitted

Link to Open Review

Open Review Page: https://openreview.net/profile?id=~Chen_Chen18

BibTex

@InProceedings{CruFid_Longitudinal_MICCAISAT2026,
        author = { Cruz, Fidel Omar Tito AND Ghafouri, Neda AND Wang, Zengyan AND Khosravi, Pegah AND Tian, Yu AND Chen, Chen},
        title = { { Longitudinal 3D Foundation Modeling for Neoadjuvant Breast Cancer Response Prediction from Serial DCE-MRI } },
        booktitle = {Medical Image Computing and Computer Assisted Intervention -- MICCAI 2026 Workshops and Challenges},
        year = {2026},
        publisher = {Springer Nature Switzerland},
        volume = {LNCS 17273},
        month = {pending},
        page = {pending}
}


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