Associations Between Dynamic Contrast Enhanced Magnetic Resonance Imaging and Clinically Relevant Histopathological Features in Breast Cancer: A Multicenter Analysis

Background/Aim: To provide data regarding relationships between quantitative dynamic contrast enhanced magnetic resonance imaging (DCE MRI) and prognostic factors in breast cancer (BC). Patients and Methods: Data from 4 Centers (200 female patients, mean age, 51.2 +/- 11.5 years) were acquired. The following data were collected: histopathological diagnosis, tumor grade, stage, hormone receptor status, KI 67, and DCE MRI values including K-trans (volume transfer constant), V-e (volume of the extravascular extracellular leakage space (EES) and K-ep (diffusion of contrast medium from the EES back to the plasma). DCE MRI values between different groups were compared using the Mann-Whitney U-test and by the Kruskal-Wallis H test. The association between DCE MRI and Ki 67 values was calculated by the Spearman's rank correlation coefficient. Results: DCE MRI values of different tumor subtypes overlapped significantly. There were no statistically significant differences of DCE MRI values between different tumor grades. All DCE MRI parameters correlated with KI-67: K-trans, r=0.44, p=0.0001; V-e, r=0.34, p=0.0001; K-ep, r=0.28, p=0.002. ROC analysis identified a K-trans threshold of 0.3 min-1 for discrimination of tumors with low KI-67 expression (<25%) and high KI-67 expression (>= 25%): sensitivity, 75.5%, specificity, 73.0%, accuracy, 74.0%, AUC, 0.78. DCE MRI values overlapped between tumors with different T and N stages. Conclusion: K-trans, K-ep, and V-e cannot be used as reliable a surrogate marker for hormone receptor status, tumor stage and grade in BC. Ktrans may discriminate lesions with high and lower proliferation activity.

Automated summary

In this study, the relationships between quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) and prognostic factors in breast cancer (BC) were investigated. The results showed that DCE MRI parameters were positively correlated with KI-67, but could not be used as reliable markers for hormone receptor status, tumor stage, and grade in BC. However, K-trans could discriminate lesions with high and low proliferation activity.