Magnetic resonance imaging reveals functional diversity of the vasculature in benign and malignant breast lesions

Abstract

BACKGROUNDTumor perfusion through the microvascular network can be imaged noninvasively by dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI). The objective of the current study was to quantify the microvascular perfusion parameters in various human breast lesions and to determine whether they varied between benign lesions and malignancy and whether they were altered with increased invasiveness.METHODSPerfusion parameters in 22 benign fibrocystic changes, 15 ductal carcinomas in situ (DCIS), 30 infiltrating ductal carcinomas (IDC), and 22 fibroadenomas were measured using high‐resolution DCE‐MRI. Pixel‐by‐pixel image analysis yielded parametric images of two perfusion indicators: the influx transcapillary transfer constant (ktrans) and the efflux transcapillary rate constant (kep). Correlations of lesion type and perfusion parameters were calculated using Spearman correlation. Logistic regression analysis evaluated the best predictors of the kinetic parameters that differentiate between IDC and benign lesions.RESULTSThe perfusion parameters exhibited a progressive increase from benign fibrocystic changes to DCIS and IDC, with a significant correlation between lesion type and the parameters' values (range of correlation coefficients, 0.56–0.76; P < 0.0001). In addition, ktrans increased from low‐grade DCIS to high‐grade DCIS. Fibroadenomas were characterized uniquely by high ktrans but low kep. Stepwise logistic regression selected ktrans as the best predictor for distinguishing benign fibrocystic changes from IDC, yielding 93% sensitivity and 96% specificity.CONCLUSIONSThe microvascular perfusion parameters in breast lesions were elevated with invasiveness. Quantification of these parameters using high‐resolution DCE‐MRI was helpful for differentiating between breast lesions and should improve breast carcinoma diagnosis. Cancer 2005. © 2005 American Cancer Society.

In vivo MRI and histopathological assessment of tumor microenvironment in luminal‐like and basal‐like breast cancer xenografts

“…Aggressive tumors are known to have a high angiogenic activity, which is essential to maintain a sufficient blood supply to the highly proliferative tumor cells. DCE-MRI is a promising tool for functional in vivo assessment of tumor vascularity (13). In this study gadodiamide was selected as the contrast agent, since it is widely used in clinical practice.…”

“…Dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) is used as a tool for in vivo characterization of tumor vasculature (10,11). Contrast enhancement kinetics obtained by DCE-MRI correlates with tumor type, histological grade, MVD, and biomarkers such as estrogen receptors (ER), progesterone receptors (PgR), and the proliferation marker Ki-67 (6,(12)(13)(14)(15)(16)(17). By using a pharmacokinetic two-compartment model, maps of tissue properties such as vascular permeability and perfusion (K trans ), extracellular extravascular volume fraction (v e ), and blood plasma volume fraction (v p ) can be obtained (18).…”

Temporal Analysis of Tumor Heterogeneity and Volume for Cervical Cancer Treatment Outcome Prediction: Preliminary Evaluation

“…The use of DCE-MRI for quantification of tumor vascularity, tumor staging, or treatment efficacy has been explored for cancers of the prostate 5,6 , colon 7 , liver 8 , breast 9 , and cervix. For the case of cervical cancer, the change in volume over the first 2-4 weeks of therapy has been shown to be related to treatment outcome 10 .…”

Estudo da permeabilidade vascular e volume extra-celular na diferenciação das lesões nodulares benignas e malignas da mama

“…[2] O tumor tem alta demanda metabólica por oxigênio e nutrientes e ela aumenta à medida que há o crescimento tumoral. Isto causa hipóxia, levando a formação de novos vasos, processo denominado angiogênese [3,[9][10][11][12] .…”

“…Degani e colaboradores [12,20] desenvolveram um modelo usando RM com contraste, com alta resolução temporal e espacial, onde com modelos matemáticos de compartimentos como os padronizados por Tofts [21] , calcula a permeabilidade vascular e VEC das lesões. [20][21][22] Existem hoje muitos aplicativos com uso de RM com contraste dinâmico para medir estes parâmetros biológicos, sendo um deles o método Full Time Point (FTP) (Cadsciences; White Plains, NY, USA), que é um sistema de detecção assistida por computador (CAD), que baseado na metodologia de Degani [20] , calcula a permeabilidade e VEC para cada pixel da lesão, traduzido em um gráfico de cores.…”