Correlation of DCE-MRI Perfusion Parameters and Molecular Biology of Breast Infiltrating Ductal Carcinoma

Abstract

ObjectiveWe aimed to investigate the correlation of the perfusion parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with the molecular biological expression of breast infiltrating ductal carcinoma (IDC) in order to guide appropriate therapeutic advice and clinical outcome prediction.Materials and MethodsIn a prospective analysis of 67 patients with breast IDC, preoperative DCE-MRI and routine MRI images were obtained. The double-chamber model (extended Tofts model) was employed to calculate the perfusion parameters. Postoperative pathological immunohistochemistry was examined, including human epidermal growth factor receptor 2 (HER-2), estrogen receptor (ER), progesterone receptor (PR), cell nuclear-associated antigen (Ki-67), cytokeratin 5/6 (CK5/6), and epidermal growth factor receptor (EGFR). Statistical analysis was applied to explore the relationship between the perfusion parameters and the molecular biomarkers of breast cancer.ResultsA total of 67 lesions were included in our study. The mean maximum diameter of lesions was 4.48 ± 1.73 cm. Perfusion parameters had no correlation with tumor diameters (p > 0.05). The volume transfer constant (Ktrans) and the rate constant (kep) had positive correlations with Ki-67 (p < 0.05). The plasma volume ratio (vp) had a statistical difference between CK5/6 positivity and CK5/6 negativity. The maximum rising slope (MAX Slope) was higher in HER-2-enriched tumors than that in luminal A or B tumors (p < 0.05). kep was higher in HER-2-enriched tumors than that in luminal A tumors (p < 0.05). The extravascular extracellular space volume fraction (ve) was higher in triple-negative tumors than that in HER-2-enriched and in luminal A and B tumors (p < 0.05). The time to peak enhancement (TTP) was lower in HER-2-enriched tumors than that in luminal A and B tumors (p < 0.05). Maximum concentration (MAX Conc) was higher in triple-negative tumors than that in luminal B tumors (p < 0.05).ConclusionDCE-MRI perfusion parameters can behave as a noninvasive tool to assess the molecular biological expression and the molecular subtypes of breast IDC. They may aid in predicting breast IDC invasiveness, metastasis, and prognosis.

Model‐Free and Model‐based Parameters Derived From CAIPIRINHA‐Dixon‐TWIST‐VIBE DCE‐MRI: Associations With Prognostic Factors and Molecular Subtypes of Invasive Ductal Breast Cancer

“…A previous study reported a correlation between microvessel density and k ep in breast cancers 23 . Multivariable analysis in our study showed lower k ep minimum and higher k ep range values in patients with HER2‐positive than in those with luminal A breast cancer tumors, which is consistent with previous research 24 . This could be due to the fact that HER2 expression correlates with vascular endothelial growth factor overexpression, which is associated with increased angiogenesis 25 …”

“…23 Multivariable analysis in our study showed lower k ep minimum and higher k ep range values in patients with HER2-positive than in those with luminal A breast cancer tumors, which is consistent with previous research. 24 This could be due to the fact that HER2 expression correlates with vascular endothelial growth factor overexpression, which is associated with increased angiogenesis. 25 Our study also demonstrated higher k ep and lower v e values in patients with IDC with a high nuclear grade, which is consistent to the results of previous studies.…”

“…6 Liu et al illustrated that K trans had positive associations with Ki-67. 24 These differences could be due to many factors, including AIF, B1 field inhomogeneity and field strength, the imaging technique, temporal resolution, and the T1 mapping sequence. 27 Furthermore, K trans values have been shown to vary as much as an order of magnitude across sites and clinical applications, 28 because K trans is influenced by the patient's age, cardiac output, and hypertension.…”

“…Kim et al found that the 50th percentile of K trans was higher in tumors larger than 2 cm than in tumors smaller than 2 cm 6 . Liu et al illustrated that K trans had positive associations with Ki‐67 24 . These differences could be due to many factors, including AIF, B1 field inhomogeneity and field strength, the imaging technique, temporal resolution, and the T1 mapping sequence 27 .…”

Effect of Neoadjuvant Chemotherapy on Angiogenesis and Cell Proliferation of Breast Cancer Evaluated by Dynamic Enhanced Magnetic Resonance Imaging

“…Quantitative dynamic enhancement parameters include the rate constant of Ktrans contrast medium diffusion from blood vessels to extravascularly and Kep intertissional dispersion back into blood vessels, Ve extravascular extracellular space volume ratio, and the proportion of extravascular intercellular space to total voxels [14][15][16]. This can not only indirectly evaluate the molecular biology of tumors but also reflect the changes of chemotherapy drugs after tumor vascular action and quantitatively evaluate the effect of chemotherapy [17][18][19]. Therefore, dynamic quantitative enhancement parameters can be used as an effective indicator for the early evaluation of neoadjuvant chemotherapy for breast cancer [20][21][22].…”