Shin Jong Ki, Kim Jin You
Medical Research Institute, Pusan National University School of Medicine, Busan, Republic of Korea.
Department of Radiology, Pusan National University Hospital, Busan, Republic of Korea.
J Magn Reson Imaging. 2017 Jan;45(1):94-102. doi: 10.1002/jmri.25348. Epub 2016 Jun 17.
To explore the association between quantitative parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) and Ki-67 proliferation status in patients with estrogen receptor (ER)-positive invasive breast cancer.
We retrospectively reviewed the records of 88 patients with ER-positive invasive breast cancer who underwent preoperative DCE-MRI and DWI on a 3T scanner. Perfusion parameters (K , K , and V ) and apparent diffusion coefficients (ADCs) were recorded, and we correlated these data with the Ki-67 status. The Ki-67 proliferation index was categorized as high (≥14%) or low (<14%).
In the high-Ki-67 group, the mean K was significantly higher (P < 0.001) than that of the low-Ki-67 group, and the mean ADC significantly lower (P < 0.001). However, the mean K and V values did not differ between the two groups (P = 0.248 and P = 0.055, respectively). Univariate analysis showed that a higher K (>0.274), a lower ADC (≤0.893 × 10 mm /s), a larger tumor size (>2 cm), a higher histological grade (grade 3), the presence of axillary metastasis, and positive P53 status were significantly associated with high-Ki-67 status (all P values < 0.05). Of these variables, a higher K (>0.274; adjusted odds ratio [OR] = 9.027, 95% confidence interval [CI] = 1.929-42.245; P = 0.005) and a higher histological grade (grade 3; adjusted OR = 7.510, 95% CI = 1.305-43.205; P = 0.024) independently predicted a high Ki-67 status.
K derived from DCE-MRI is associated independently with the Ki-67 proliferation status in patients with ER-positive invasive breast cancer.
4 J. Magn. Reson. Imaging 2017;45:94-102.
探讨动态对比增强磁共振成像（DCE-MRI）和扩散加权成像（DWI）得出的定量参数与雌激素受体（ER）阳性浸润性乳腺癌患者Ki-67增殖状态之间的关联。
我们回顾性分析了88例ER阳性浸润性乳腺癌患者的记录，这些患者在3T扫描仪上接受了术前DCE-MRI和DWI检查。记录灌注参数（Ktrans、Kep和Ve）和表观扩散系数（ADC），并将这些数据与Ki-67状态进行关联。Ki-67增殖指数分为高（≥14%）或低（<14%）。
在高Ki-67组中，平均Ktrans显著高于低Ki-67组（P<0.001），平均ADC显著低于低Ki-67组（P<0.001）。然而，两组之间的平均Kep和Ve值没有差异（分别为P=0.248和P=0.055）。单因素分析显示，较高的Ktrans（>0.274）、较低的ADC（≤0.893×10⁻³mm²/s）、较大的肿瘤大小（>2cm）、较高的组织学分级（3级）、腋窝转移的存在以及P53状态阳性与高Ki-67状态显著相关（所有P值<0.05）。在这些变量中，较高的Ktrans（>0.274；调整后的优势比[OR]=9.027，95%置信区间[CI]=1.929-42.245；P=0.005）和较高的组织学分级（3级；调整后的OR=7.510，95%CI=1.305-43.205；P=0.024）独立预测高Ki-67状态。
DCE-MRI得出的Ktrans与ER阳性浸润性乳腺癌患者的Ki-67增殖状态独立相关。
4 J.Magn.Reson.Imaging 2017；45：94-102。
