Wen-Jie Tang1, Zhe Jin1, Yan-Ling Zhang2, Yun-Shi Liang3, Zi-Xuan Cheng1, Lei-Xin Chen1, Ying-Ying Liang1, Xin-Hua Wei1, Qing-Cong Kong4, Yuan Guo1, Xin-Qing Jiang1. 1. Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China. 2. Department of Ultrasound, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China. 3. Department of Pathology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China. 4. Department of Radiology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Abstract
PURPOSE: To assess whether apparent diffusion coefficient (ADC) metrics can be used to assess tumor-infiltrating lymphocyte (TIL) levels in breast cancer, particularly in the molecular subtypes of breast cancer. METHODS: In total, 114 patients with breast cancer met the inclusion criteria (mean age: 52 years; range: 29-85 years) and underwent multi-parametric breast magnetic resonance imaging (MRI). The patients were imaged by diffusion-weighted (DW)-MRI (1.5 T) using a single-shot spin-echo echo-planar imaging sequence. Two readers independently drew a region of interest (ROI) on the ADC maps of the whole tumor. The mean ADC and histogram parameters (10th, 25th, 50th, 75th, and 90th percentiles of ADC, skewness, entropy, and kurtosis) were used as features to analyze associations with the TIL levels in breast cancer. Additionally, the correlation between the ADC values and Ki-67 expression were analyzed. Continuous variables were compared with Student's t-test or Mann-Whitney U test if the variables were not normally distributed. Categorical variables were compared using Pearson's chi-square test or Fisher's exact test. Associations between TIL levels and imaging features were evaluated by the Mann-Whitney U and Kruskal-Wallis tests. RESULTS: A statistically significant difference existed in the 10th and 25th percentile ADC values between the low and high TIL groups in breast cancer (P=0.012 and 0.027). For the luminal subtype of breast cancer, the 10th percentile ADC value was significantly lower in the low TIL group (P=0.041); for the non-luminal subtype of breast cancer, the kurtosis was significantly lower in the low TIL group (P=0.023). The Ki-67 index showed statistical significance for evaluating the TIL levels in breast cancer (P=0.007). Additionally, the skewness was significantly higher for samples with high Ki-67 levels in breast cancer (P=0.029). CONCLUSIONS: Our findings suggest that whole-lesion ADC histogram parameters can be used as surrogate biomarkers to evaluate TIL levels in molecular subtypes of breast cancer.
PURPOSE: To assess whether apparent diffusion coefficient (ADC) metrics can be used to assess tumor-infiltrating lymphocyte (TIL) levels in breast cancer, particularly in the molecular subtypes of breast cancer. METHODS: In total, 114 patients with breast cancer met the inclusion criteria (mean age: 52 years; range: 29-85 years) and underwent multi-parametric breast magnetic resonance imaging (MRI). The patients were imaged by diffusion-weighted (DW)-MRI (1.5 T) using a single-shot spin-echo echo-planar imaging sequence. Two readers independently drew a region of interest (ROI) on the ADC maps of the whole tumor. The mean ADC and histogram parameters (10th, 25th, 50th, 75th, and 90th percentiles of ADC, skewness, entropy, and kurtosis) were used as features to analyze associations with the TIL levels in breast cancer. Additionally, the correlation between the ADC values and Ki-67 expression were analyzed. Continuous variables were compared with Student's t-test or Mann-Whitney U test if the variables were not normally distributed. Categorical variables were compared using Pearson's chi-square test or Fisher's exact test. Associations between TIL levels and imaging features were evaluated by the Mann-Whitney U and Kruskal-Wallis tests. RESULTS: A statistically significant difference existed in the 10th and 25th percentile ADC values between the low and high TIL groups in breast cancer (P=0.012 and 0.027). For the luminal subtype of breast cancer, the 10th percentile ADC value was significantly lower in the low TIL group (P=0.041); for the non-luminal subtype of breast cancer, the kurtosis was significantly lower in the low TIL group (P=0.023). The Ki-67 index showed statistical significance for evaluating the TIL levels in breast cancer (P=0.007). Additionally, the skewness was significantly higher for samples with high Ki-67 levels in breast cancer (P=0.029). CONCLUSIONS: Our findings suggest that whole-lesion ADC histogram parameters can be used as surrogate biomarkers to evaluate TIL levels in molecular subtypes of breast cancer.
Authors: Marco Fogante; Corrado Tagliati; Mariagrazia De Lisa; Rossana Berardi; Gian Marco Giuseppetti; Andrea Giovagnoni Journal: Radiol Med Date: 2019-02-26 Impact factor: 3.469
Authors: R Salgado; C Denkert; S Demaria; N Sirtaine; F Klauschen; G Pruneri; S Wienert; G Van den Eynden; F L Baehner; F Penault-Llorca; E A Perez; E A Thompson; W F Symmans; A L Richardson; J Brock; C Criscitiello; H Bailey; M Ignatiadis; G Floris; J Sparano; Z Kos; T Nielsen; D L Rimm; K H Allison; J S Reis-Filho; S Loibl; C Sotiriou; G Viale; S Badve; S Adams; K Willard-Gallo; S Loi Journal: Ann Oncol Date: 2014-09-11 Impact factor: 32.976
Authors: Jin You Kim; Jin Joo Kim; Ji Won Lee; Nam Kyung Lee; Geewon Lee; Taewoo Kang; Heesung Park; Yo Han Son; Robert Grimm Journal: Eur Radiol Date: 2018-08-02 Impact factor: 5.315
Authors: Sathana Dushyanthen; Paul A Beavis; Peter Savas; Zhi Ling Teo; Chenhao Zhou; Mariam Mansour; Phillip K Darcy; Sherene Loi Journal: BMC Med Date: 2015-08-24 Impact factor: 8.775
Authors: Jan Hudeček; Leonie Voorwerk; Maartje van Seijen; Iris Nederlof; Michiel de Maaker; Jose van den Berg; Koen K van de Vijver; Karolina Sikorska; Sylvia Adams; Sandra Demaria; Giuseppe Viale; Torsten O Nielsen; Sunil S Badve; Stefan Michiels; William Fraser Symmans; Christos Sotiriou; David L Rimm; Stephen M Hewitt; Carsten Denkert; Sibylle Loibl; Sherene Loi; John M S Bartlett; Giancarlo Pruneri; Deborah A Dillon; Maggie C U Cheang; Andrew Tutt; Jacqueline A Hall; Zuzana Kos; Roberto Salgado; Marleen Kok; Hugo M Horlings Journal: NPJ Breast Cancer Date: 2020-05-12