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
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