4.2 Article

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

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IN VIVO
卷 36, 期 1, 页码 398-408

出版社

INT INST ANTICANCER RESEARCH
DOI: 10.21873/invivo.12717

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Breast cancer; DCE MRI; KI 67; hormone receptor

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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.
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.

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