Prognostic value DCE-MRI parameters in predicting factor disease free survival and overall survival for breast cancer patients

Purpose: The aim of the study is to assess the predictive power of DCE-MRI semi-quantitative parameters during treatment of breast cancer, for disease-free (DFS) and overall survival (OS). Materials and methods: Forty-nine women (age range, 28-84 years; mean, 50.6 years) with breast cancer underwent dynamic contrast enhancement MRI at 1.0 T imaging, using 2D FLASH sequences. Time intensity curves (TICs) were obtained from the regions showing maximal enhancement in subtraction images. Semi-quantitative parameters (TICs; maximal relative enhancement within the first minute, E (max/1); maximal relative enhancement of the entire study, E-max; steepest slope of the contrast enhancement curve; and time to peak enhancement) derived from the DCE-MRI data. These parameters were then compared with presence of recurrence or metastasis, DFS and OS by using Cox regression (proportional hazards model) analysis, linear discriminant analysis. Results: The results from of the 49 patients enrolled into the survival analysis demonstrated that traditional prognostic parameters (tumor size and nodal metastasis) and semi-quantitative parameters (E-max/1, and steepest slope) demonstrated significant differences in survival intervals (p < 0.05). Further Cox regression (proportional hazards model) survival analysis revealed that semi-quantitative parameters contributed the greatest prediction of both DFS, OS in the resulting models (for E-max/1: p = 0.013, hazard ratio 1.022; for stepest slope: p = 0.004, hazard ratio 1.584). Conclusion: This study shows that DCE-MRI has utility predicting survival analysis with breast cancer patients. (C) 2011 Elsevier Ireland Ltd. All rights reserved.