Dynamic Contrast-Enhanced MRI Kinetics of Invasive Breast Cancer: A Potential Prognostic Marker for Radiation Therapy

Loiselle, Christopher; Eby, Peter R.; DeMartini, Wendy B.; Peacock, Sue; Bittner, Nathan; Lehman, Constance D.; Kim, Janice N.

doi:10.1016/j.ijrobp.2009.03.053

Cited by 13 publications

(6 citation statements)

References 34 publications

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“…In previous reports, high microvessel density and increased vascular permeability were associated with a higher nuclear grade [ 28 ], axillary lymph node metastasis, and distant metastasis [ 4 , 21 , 29 ]. Other studies have shown that peak enhancement was significantly greater among patients with lymph node metastasis and lymph node extracapsular extension [ 30 , 31 ]. We believe that these results might explain the relationship between the peak enhancement on DCE MR imaging and poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

Preoperative dynamic breast magnetic resonance imaging kinetic features using computer-aided diagnosis: Association with survival outcome and tumor aggressiveness in patients with invasive breast cancer

Nam

Lim

et al. 2018

PLoS ONE

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ObjectivesTo evaluate whether preoperative breast dynamic contrast-enhanced (DCE) magnetic resonance (MR) imaging kinetic features, assessed using computer-aided diagnosis (CAD), can predict survival outcome and tumor aggressiveness in patients with invasive breast cancer.Materials and methodsBetween March and December 2011, 301 women who underwent preoperative DCE MR imaging for invasive breast cancer, with CAD data, were identified. All MR images were retrospectively evaluated using a commercially available CAD system. The following kinetic parameters were prospectively recorded for each lesion: initial peak enhancement, the proportion of early phase medium and rapid enhancement, and the proportion of delayed phase persistent, plateau, and washout enhancement. The Cox proportional hazards model was used to determine the association between the kinetic features assessed by CAD and disease-free survival (DFS). The peak signal intensity and kinetic enhancement profiles were compared with the clinical-pathological variables.ResultsThere were 32 recurrences during a mean follow-up time of 55.2 months (range, 5–72 months). Multivariate analysis revealed that a higher peak enhancement (DFS hazard ratio, 1.004 [95% confidence interval (CI): 1.001, 1.006]; P = .013) on DCE MR imaging and a triple-negative subtype (DFS hazard ratio, 21.060 [95% CI: 2.675, 165.780]; P = .004) were associated with a poorer DFS. Higher peak enhancement was significantly associated with a higher tumor stage, clinical stage, and histologic grade.ConclusionsPatients with breast cancer who showed higher CAD-derived peak enhancement on breast MR imaging had worse DFS. Peak enhancement and volumetric analysis of kinetic patterns were useful for predicting tumor aggressiveness.

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Section: Discussionmentioning

confidence: 99%

Preoperative dynamic breast magnetic resonance imaging kinetic features using computer-aided diagnosis: Association with survival outcome and tumor aggressiveness in patients with invasive breast cancer

Nam

Lim

et al. 2018

PLoS ONE

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“…These studies try to correlate the DCE-MRI measurements with diseases, as will be discussed below. DCE-MRIbased diagnosis has been explored in different clinical studies, including monitoring the effects of chemotherapy in bone sarcomas or melanoma, 27,28 head and neck, [29][30][31] cardiac, 5,[32][33][34][35][36][37][38][39][40] pelvic, 41 rectal, [42][43][44][45][46][47] pancreatic cancer, 48 liver, 49 lung, 50 colon, 51 breast, [52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68] uterus, [69][70][71][72][73][74]…”

Section: A Clinical Applications Of Nonparametric Approachesmentioning

confidence: 99%

Models and methods for analyzing DCE‐MRI: A review

Khalifa¹,

Soliman²,

El-Baz³

et al. 2014

Medical Physics

242

230

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“…Based on findings that Dynamic Contrast Enhanced MRI (DCE-MRI) kinetics of primary breast cancers are correlated with axillary lymph node status (14–16), we hypothesized that DCE-MRI will improve our ability to predict the presence of extensive additional axillary disease after a positive sentinel lymph node biopsy and add predictive value to the Katz nomogram. To our knowledge, no published studies have investigated the approach of combining DCE-MRI tumor kinetics features with the Katz nomogram to improve prediction of axillary node involvement.…”

Section: Introductionmentioning

confidence: 99%

Preoperative MRI Improves Prediction of Extensive Occult Axillary Lymph Node Metastases in Breast Cancer Patients with a Positive Sentinel Lymph Node Biopsy

et al. 2014

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Rationale and Objectives To test the ability of quantitative measures from preoperative Dynamic Contrast Enhanced MRI (DCE-MRI) to predict, independently and/or with the Katz pathologic nomogram, which breast cancer patients with a positive sentinel lymph node biopsy will have ≥ 4 positive axillary lymph nodes upon completion axillary dissection. Methods and Materials A retrospective review was conducted to identify clinically node-negative invasive breast cancer patients who underwent preoperative DCE-MRI, followed by sentinel node biopsy with positive findings and complete axillary dissection (6/2005 – 1/2010). Clinical/pathologic factors, primary lesion size and quantitative DCE-MRI kinetics were collected from clinical records and prospective databases. DCE-MRI parameters with univariate significance (p < 0.05) to predict ≥ 4 positive axillary nodes were modeled with stepwise regression and compared to the Katz nomogram alone and to a combined MRI-Katz nomogram model. Results Ninety-eight patients with 99 positive sentinel biopsies met study criteria. Stepwise regression identified DCE-MRI total persistent enhancement and volume adjusted peak enhancement as significant predictors of ≥4 metastatic nodes. Receiver operating characteristic (ROC) curves demonstrated an area under the curve (AUC) of 0.78 for the Katz nomogram, 0.79 for the DCE-MRI multivariate model, and 0.87 for the combined MRI-Katz model. The combined model was significantly more predictive than the Katz nomogram alone (p = 0.003). Conclusion Integration of DCE-MRI primary lesion kinetics significantly improved the Katz pathologic nomogram accuracy to predict presence of metastases in ≥ 4 nodes. DCE-MRI may help identify sentinel node positive patients requiring further localregional therapy.

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Dynamic Contrast-Enhanced MRI Kinetics of Invasive Breast Cancer: A Potential Prognostic Marker for Radiation Therapy

Cited by 13 publications

References 34 publications

Preoperative dynamic breast magnetic resonance imaging kinetic features using computer-aided diagnosis: Association with survival outcome and tumor aggressiveness in patients with invasive breast cancer

Preoperative dynamic breast magnetic resonance imaging kinetic features using computer-aided diagnosis: Association with survival outcome and tumor aggressiveness in patients with invasive breast cancer

Models and methods for analyzing DCE‐MRI: A review

Preoperative MRI Improves Prediction of Extensive Occult Axillary Lymph Node Metastases in Breast Cancer Patients with a Positive Sentinel Lymph Node Biopsy

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