Zhilong Yi1,2, Mingwei Xie2, Guangzi Shi2, Ziliang Cheng2, Hong Zeng3, Ningyi Jiang1, Zhuo Wu4,5. 1. Department of Nuclear Medicine, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518107, China. 2. Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou, 510120, China. 3. Department of Pathology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou, 510120, China. 4. Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou, 510120, China. wuzhuo@mail.sysu.edu.cn. 5. Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Road West, Guangzhou, 510120, China. wuzhuo@mail.sysu.edu.cn.
Abstract
OBJECTIVES: To investigate whether quantitative DCE-MRI (qDCE-MRI) could help distinguish breast phyllodes tumor (PT) grades. MATERIALS AND METHODS: This retrospective study included 67 breast PTs (26 benign lesions, 25 borderline lesions, and 16 malignant lesions) from April 2016 to July 2020. MRI was performed with a 1.5-T MR system. Perfusion parameters (Ktrans, kep, ve, iAUC60) derived from qDCE-MRI, tumor size, and the mean ADC value were correlated with histologic grades using Spearman's rank correlation coefficient. Ktrans, kep, ve, and iAUC60 of three histologic grades were also calculated and compared. RESULTS: The Spearman correlation coefficient with histologic grade of the tumor size was 0.578 (p < 0.001); the ADC value was not correlated with histologic grades of breast PT (p = 0.059). The Ktrans, kep, ve, and iAUC60 of benign breast PTs were significantly lower than those of borderline breast PTs (p < 0.001) and lower than those of malignant breast PTs (p < 0.001). In comparison, the Ktrans, ve, and iAUC60 of borderline breast PTs were significantly lower than those of malignant breast PTs (p < 0.001, p < 0.001, p = 0.007, respectively). For ROC analysis, AUCs of Ktrans, ve, and iAUC60 were higher than tumor size and ADC value for differentiating three PT grades. CONCLUSION: Quantitative and semi-quantitative perfusion parameters (Ktrans, ve, and iAUC60, especially Ktrans) derived from qDCE-MRI showed better diagnosis efficiency than tumor size and ADC for grading breast PTs. Therefore, qDCE-MRI may be helpful for preoperative differentiating breast PT grades. KEY POINTS: • Quantitative dynamic contrast-enhanced MRI can be used as a complementary noninvasive method to improve the differential diagnosis of breast PT. • Ktrans, ve, and iAUC60 derived from qDCE-MRI showed better diagnosis efficiency than tumor size and ADC for grading breast PTs.
OBJECTIVES: To investigate whether quantitative DCE-MRI (qDCE-MRI) could help distinguish breast phyllodes tumor (PT) grades. MATERIALS AND METHODS: This retrospective study included 67 breast PTs (26 benign lesions, 25 borderline lesions, and 16 malignant lesions) from April 2016 to July 2020. MRI was performed with a 1.5-T MR system. Perfusion parameters (Ktrans, kep, ve, iAUC60) derived from qDCE-MRI, tumor size, and the mean ADC value were correlated with histologic grades using Spearman's rank correlation coefficient. Ktrans, kep, ve, and iAUC60 of three histologic grades were also calculated and compared. RESULTS: The Spearman correlation coefficient with histologic grade of the tumor size was 0.578 (p < 0.001); the ADC value was not correlated with histologic grades of breast PT (p = 0.059). The Ktrans, kep, ve, and iAUC60 of benign breast PTs were significantly lower than those of borderline breast PTs (p < 0.001) and lower than those of malignant breast PTs (p < 0.001). In comparison, the Ktrans, ve, and iAUC60 of borderline breast PTs were significantly lower than those of malignant breast PTs (p < 0.001, p < 0.001, p = 0.007, respectively). For ROC analysis, AUCs of Ktrans, ve, and iAUC60 were higher than tumor size and ADC value for differentiating three PT grades. CONCLUSION: Quantitative and semi-quantitative perfusion parameters (Ktrans, ve, and iAUC60, especially Ktrans) derived from qDCE-MRI showed better diagnosis efficiency than tumor size and ADC for grading breast PTs. Therefore, qDCE-MRI may be helpful for preoperative differentiating breast PT grades. KEY POINTS: • Quantitative dynamic contrast-enhanced MRI can be used as a complementary noninvasive method to improve the differential diagnosis of breast PT. • Ktrans, ve, and iAUC60 derived from qDCE-MRI showed better diagnosis efficiency than tumor size and ADC for grading breast PTs.
Authors: Benjamin Y Tan; Geza Acs; Sophia K Apple; Sunil Badve; Ira J Bleiweiss; Edi Brogi; José P Calvo; David J Dabbs; Ian O Ellis; Vincenzo Eusebi; Gelareh Farshid; Stephen B Fox; Shu Ichihara; Sunil R Lakhani; Emad A Rakha; Jorge S Reis-Filho; Andrea L Richardson; Aysegul Sahin; Fernando C Schmitt; Stuart J Schnitt; Kalliopi P Siziopikou; Fernando A Soares; Gary M Tse; Anne Vincent-Salomon; Puay Hoon Tan Journal: Histopathology Date: 2016-01 Impact factor: 5.087