Se Ri Kang1, Hye Won Kim2, Hun Soo Kim3. 1. Department of Radiology, Wonkwang University Hospital, Iksan, Republic of Korea. 2. Department of Radiology, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Republic of Korea. 3. Department of Pathology, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Republic of Korea.
Abstract
BACKGROUND: Dynamic contrast-enhanced MRI (DCE-MRI) is used to evaluate tumor microvasculature. However, studies demonstrating an association between perfusion parameters derived from DCE-MRI and histopathologic characteristics are limited to a small set of histopathologic factors, and the results are inconsistent. PURPOSE: To evaluate the relationship between DCE-MRI perfusion parameters and common histopathologic tumor characteristics used to predict angiogenesis and determine prognosis in breast cancer. STUDY TYPE: Retrospective. POPULATION: In all, 105 breast cancer patients with invasive ductal carcinoma (122 lesions). FIELD STRENGTH/SEQUENCE: 3.0T, turbo spin-echo (TSE) T1 -weighted, fat-suppressed T2 -weighted, TSE T2 -weighted, and dynamic unenhanced and contrast-enhanced 3D T1 high-resolution isotropic volume examination. ASSESSMENT: One reviewer obtained perfusion parameters (Ktrans , kep , ve , and vp ) of each breast cancer from DCE MRI using the extended Tofts model with a fixed baseline T1 value and a population-based arterial input function. The relationship between DCE-MRI perfusion parameters and histopathologic tumor characteristics used to predict angiogenesis and determine prognosis was evaluated. STATISTICAL TESTS: Student's t-test, Mann-Whitney U-test, analysis of variance (ANOVA), and Kruskal-Wallis test were used. RESULTS: Triple-negative breast cancers exhibited higher Ktrans and kep than luminal cancers (P < 0.05). Estrogen receptor (ER)-negative tumors showed higher Ktrans than ER-positive tumors (P < 0.05). Progesterone receptor (PR)-negative tumors presented higher ve than PR-positive tumors (P < 0.05). Tumors with higher Ki-67 showed higher kep than tumors with lower Ki-67 (P < 0.05). P53-positive tumors exhibited higher Ktrans and kep than p53-negative tumors (P < 0.05). Higher histologic grade tumors (grade II/III) presented higher Ktrans , kep , vp (P < 0.05) than grade I tumors. Tumors with LVSI presented higher Ktrans and kep than tumors without LVSI (P < 0.05). DATA CONCLUSION: Breast cancer presenting higher Ktrans and kep on DCE-MRI was associated with poor prognostic histopathologic factors. Therefore, pretreatment DCE-MRI perfusion parameters may be useful imaging biomarkers for the evaluation of tumor prognosis and angiogenesis. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY STAGE: 2.
BACKGROUND: Dynamic contrast-enhanced MRI (DCE-MRI) is used to evaluate tumor microvasculature. However, studies demonstrating an association between perfusion parameters derived from DCE-MRI and histopathologic characteristics are limited to a small set of histopathologic factors, and the results are inconsistent. PURPOSE: To evaluate the relationship between DCE-MRI perfusion parameters and common histopathologic tumor characteristics used to predict angiogenesis and determine prognosis in breast cancer. STUDY TYPE: Retrospective. POPULATION: In all, 105 breast cancerpatients with invasive ductal carcinoma (122 lesions). FIELD STRENGTH/SEQUENCE: 3.0T, turbo spin-echo (TSE) T1 -weighted, fat-suppressed T2 -weighted, TSE T2 -weighted, and dynamic unenhanced and contrast-enhanced 3D T1 high-resolution isotropic volume examination. ASSESSMENT: One reviewer obtained perfusion parameters (Ktrans , kep , ve , and vp ) of each breast cancer from DCE MRI using the extended Tofts model with a fixed baseline T1 value and a population-based arterial input function. The relationship between DCE-MRI perfusion parameters and histopathologic tumor characteristics used to predict angiogenesis and determine prognosis was evaluated. STATISTICAL TESTS: Student's t-test, Mann-Whitney U-test, analysis of variance (ANOVA), and Kruskal-Wallis test were used. RESULTS: Triple-negative breast cancers exhibited higher Ktrans and kep than luminal cancers (P < 0.05). Estrogen receptor (ER)-negative tumors showed higher Ktrans than ER-positive tumors (P < 0.05). Progesterone receptor (PR)-negative tumors presented higher ve than PR-positive tumors (P < 0.05). Tumors with higher Ki-67 showed higher kep than tumors with lower Ki-67 (P < 0.05). P53-positive tumors exhibited higher Ktrans and kep than p53-negative tumors (P < 0.05). Higher histologic grade tumors (grade II/III) presented higher Ktrans , kep , vp (P < 0.05) than grade I tumors. Tumors with LVSI presented higher Ktrans and kep than tumors without LVSI (P < 0.05). DATA CONCLUSION:Breast cancer presenting higher Ktrans and kep on DCE-MRI was associated with poor prognostic histopathologic factors. Therefore, pretreatment DCE-MRI perfusion parameters may be useful imaging biomarkers for the evaluation of tumor prognosis and angiogenesis. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY STAGE: 2.
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