Correlation between magnetic resonance imaging and the level of tumor-infiltrating lymphocytes in patients with estrogen receptor-negative HER2-positive breast cancer

Choi, Woo Jung; Kim, Youyeon; Hee, Joo; Shin, Hee Jung; Chae, Eun Young; Kim, Hak Hee

doi:10.1177/0284185119851235

Cited by 13 publications

(16 citation statements)

References 26 publications

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“…3) [37]. Low tumor peak enhancement at MRI indicating less aggressiveness was significantly associated with high TILs (OR, 1.01; p = .020) [38]. These results are consistent with previous studies showing that TILs observed in breast cancers were associated with higher rate of pCR or improved overall survival outcomes [5,6].…”

Section: Luminal Subtypesupporting

confidence: 85%

Imaging features of breast cancer molecular subtypes: state of the art

Cho

2021

J Pathol Transl Med

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Characterization of breast cancer molecular subtypes has been the standard of care for breast cancer management. We aimed to provide a review of imaging features of breast cancer molecular subtypes for the field of precision medicine. We also provide an update on the recent progress in precision medicine for breast cancer, implications for imaging, and recent observations in longitudinal functional imaging with radiomics.

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Section: Luminal Subtypesupporting

confidence: 85%

Imaging features of breast cancer molecular subtypes: state of the art

Cho

2021

J Pathol Transl Med

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“…The contrast enhancement patterns of breast MRI were associated with angiogenesis 34 . Choi et al 32 evaluated the kinetic enhancement pattern and reported that high peak enhancement was significantly associated with low TILs. Among the quantitative parameters of CEUS, the lesions with high TILs had higher PI values, which was known to be linked with more angiogenesis.…”

Section: Discussionmentioning

confidence: 99%

Evaluating Tumor‐Infiltrating Lymphocytes in Breast Cancer

Jia

Zhu

et al. 2022

J of Ultrasound Medicine

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Objectives Tumor‐infiltrating lymphocytes (TILs) have emerged as an efficient biomarker predicting treatment response and prognosis of breast cancer (BC). This study aimed to evaluate the association between conventional ultrasound and contrast‐enhanced ultrasound (CEUS) imaging features with TIL levels in invasive BC patients. Methods We retrospectively included 267 women with invasive BC who had undergone conventional ultrasound and CEUS. Patients were divided into low (≤10%) and high (>10%) TIL groups. Conventional ultrasound and CEUS features were analyzed by two sonographers. The associations between the TIL levels and imaging features were evaluated. Results Of the 267 patients, 122 with high TILs and 145 with low TIL levels. High TIL tumors were more likely to have a circumscribed margin, oval or round shape, and enhanced posterior echoes on ultrasonography (p < 0.05). In contrast, low TIL tumors were more likely to have an irregular shape, un‐circumscribed, indistinct and spiculated margin (p < 0.05). In CEUS, high TIL tumors showed a more regular shape, clearer margin, more homogeneous enhancement and higher peak intensity (PI) value (p < 0.05). Logistic analysis indicated that shape, posterior features, PI, and enhanced homogeneity were independent predictors for high TIL tumors. The model combined the four independent predictors have a moderate performance in predicting high TIL tumors with AUC 0.79, sensitivity 0.72, and specificity 0.78. Conclusions Conventional ultrasound and CEUS features were associated with TIL levels in invasive BC. Consequently, the results suggested that preoperative conventional ultrasound and CEUS may be a useful noninvasive imaging biomarker for individualized treatment decisions.

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“…32,35 Interestingly, this is not consistent with our results, as these previous studies excluded the non-mass-like lesions, and as the differences in the size and placement of ROIs may change the ADC values. Ku et al 33 found that persistent kinetic enhancement is associated with a low TIL level in TNBC, and Choi et al 36 reported that high peak enhancement was significantly associated with low TILs in TNBC and HER2-positive breast cancer. These two findings by Ku et al and Choi et al also contrasted the current study, in which no significant difference was observed between TIC curve and TIL levels.…”

Section: Discussionmentioning

confidence: 99%

Evaluating Tumor‐Infiltrating Lymphocytes in Breast Cancer Using Preoperative MRI‐Based Radiomics

Bian

Lin

et al. 2021

Magnetic Resonance Imaging

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Background Evaluating tumor‐infiltrating lymphocytes (TILs) in patients with breast cancer using radiomics has been rarely explored. Purpose To establish a radiomics nomogram based on dynamic contrast‐enhanced (DCE) magnetic resonance imaging (MRI) for preoperatively evaluating TIL level. Study Type Retrospective. Population A total of 154 patients with breast cancer were divided into a training cohort (N = 87) and a test cohort (N = 67), who were further divided into low TIL (<50%) and high TIL (≥50%) subgroups according to the histopathological results. Field Strength/Sequence 3.0 T; axial T2‐weighted imaging (fast spin echo), diffusion‐weighted imaging (spin echo‐echo planar imaging), and the volume imaging for breast assessment DCE sequence (gradient recalled echo). Assessment A radiomics signature was developed from the training dataset and independent risk factors were selected by multivariate logistic regression to build a clinical model. A nomogram model was built by combining radiomics score and risk factors. The performance of the nomogram was assessed using calibration curves and decision curves. The area under the receiver operating characteristic (ROC) curve, accuracy, sensitivity, and specificity were calculated. Statistical Tests The least absolute shrinkage and selection operator, univariate and multivariate logistic regression analysis, t‐tests and chi‐squared tests or Fisher's exact test, Hosmer–Lemeshow test, ROC analysis, and decision curve analysis were conducted. P < 0.05 was considered statistically significant. Results The radiomics signature and nomogram model exhibited better calibration and validation performance in the training (radiomics: area under the curve [AUC] 0.86; nomogram: AUC 0.88) and test (radiomics: AUC 0.83; nomogram: AUC 0.84) datasets compared with clinical model (training: AUC 0.76; test: AUC 0.72). The decision curve demonstrated that the nomogram model exhibited better performance than the clinical model, with a threshold probability between 0.15 and 0.9. Data Conclusion The nomogram model based on preoperative MRI exhibited an excellent ability for the noninvasive evaluation of TILs in breast cancer. Level of Evidence 4 Technical Efficacy Stage 2

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Correlation between magnetic resonance imaging and the level of tumor-infiltrating lymphocytes in patients with estrogen receptor-negative HER2-positive breast cancer

Cited by 13 publications

References 26 publications

Imaging features of breast cancer molecular subtypes: state of the art

Imaging features of breast cancer molecular subtypes: state of the art

Evaluating Tumor‐Infiltrating Lymphocytes in Breast Cancer

Evaluating Tumor‐Infiltrating Lymphocytes in Breast Cancer Using Preoperative MRI‐Based Radiomics

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