Quantitative Three-Dimensional Assessment of the Pharmacokinetic Parameters of Intra- and Peri-tumoural Tissues on Breast Dynamic Contrast-Enhanced Magnetic Resonance Imaging

Abstract

We aimed to assess the feasibility of three-dimensional (3D) segmentation and to investigate whether semi-quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters are associated with traditional prognostic factors for breast cancer. In addition, we evaluated whether both intra-tumoural and peri-tumoural DCE parameters can differentiate the breast cancers that are more aggressive from those that are less aggressive. Consecutive patients with newly diagnosed invasive breast cancer and structural breast MRI (3.0 T) were included after informed consent. Fifty-six patients (mean age, 57 years) with mass lesions of > 7 mm in diameter were included. A semi-automatic image post-processing algorithm was developed to measure 3D pharmacokinetic information from the DCE-MRI images. The kinetic parameters were extracted from time-signal curves, and the absolute tissue contrast agent concentrations were calculated with a reference tissue model. Markedly, higher intra-tumoural and peri-tumoural tissue concentrations of contrast agent were found in high-grade tumours (n = 44) compared to low-grade tumours (n = 12) at every time point (P = 0.006–0.040), providing positive predictive values of 90.6–92.6% in the classification of high-grade tumours. The intra-tumoural and peri-tumoural signal enhancement ratios correlated with tumour grade, size, and Ki67 activity. The intra-observer reproducibility was excellent. We developed a model to measure the 3D intensity data of breast cancers. Low- and high-grade tumours differed in their intra-tumoural and peri-tumoural enhancement characteristics. We anticipate that pharmacokinetic parameters will be increasingly used as imaging biomarkers to model and predict tumour behavior, prognoses, and responses to treatment.

Predictive Value of Preoperative Dynamic Contrast-Enhanced MRI Imaging Features in Breast Cancer Patients with Postoperative Recurrence Time

“…The values of Max Conc, AUC, and Max Slope in the early recurrence group were higher than those in the late recurrence group ( P < 0.05). The reason is that tumor recurrence depends on abundant blood supply, and DCE-MRI can display the vascular properties of tumor sites through intravenous injection of contrast agents, so the recurrence time of tumor can be predicted by observing the results of DCE-MRI [ 6 ]. The Max Conc value is the maximum concentration of contrast agent in the lesion.…”

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

“…DCE-MRI is the most mature method of breast MRI, which provides a good image of tumor morphology, suggests the hemodynamic characteristics of cancer foci, and can quantitatively and semiquantitatively analyze vascular parameters [12,13]. 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].…”

Predictive value of background parenchymal enhancement on breast magnetic resonance imaging for pathological tumor response to neoadjuvant chemotherapy in breast cancers: a systematic review

“…A critical step in quantitative BPE assessment is ROI selection. A few studies that predicted the outcome of patients with breast cancer after NACT chose ROIs focused on the tumor or the peri-tumor region [ 29 ]. Since the mammary gland is a symmetrical organ, and BPE is an intrinsic feature of breast parenchyma, most of the included literature quantitatively measured the contralateral breast and avoided tumor interference in ROI selection.…”