Department of Radiology, Anatomo-Pathology and Oncology, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy.
Department of Surgical Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161 Rome, Italy.
Acad Radiol. 2019 May;26(5):620-625. doi: 10.1016/j.acra.2018.06.014. Epub 2018 Aug 23.
The aim of this study was to retrospectly investigate the association between different breast cancer (BC) immunohistochemical subtypes and morphological and semiquantitative kinetic analysis on breast magnetic resonance imaging (MRI) performed before surgery treatment. Specifically we aimed to assess MRI features of triple-negative breast cancer (TNBC) compared to the other BC subtypes (nTNBC).
Patients undergone to breast MRI and then diagnosed with BC by core-needle biopsy were included. The MRI morphological and kinetic features were studied. Parametric and non-parametric tests were used, as appropriate.
Seventy-five BC patients were considered, 30 patients included in TNBC Group and 45 patients included in nTNBC Group. We found in TNBC Group a greater mean lesion size (P <0.001), a rim enhancement imaging (P=0.003), and a higher intratumoral signal intensity on T2-weighted images (P=0.03) with respect to nTNBC Group. We noticed that TNBC patients presented a lower grade of BPE when compared to the nTBC Group (P< 0.02). TNBC Group showed lower EPeak values (P=0.003) and higher SER values (P=0.02) with respect to the nTNBC Group. In addition, stratifying kinetics parameters according to the tumor grade, the TNBC Group presented higher tumor grade (G3) (P< 0.005) and this subgroup had higher SER values when compared to TNBCs showing a lower tumor grade (G1 and G2) (P=0.03).
After validation by large-scale studies, the morphological and semiquantitative kinetic analysis on dynamic contrast enhanced MRI may help in the pretreatment risk stratification of patients with TNBC and in evidence-based clinical decision support.
本研究旨在回顾性分析乳腺癌（BC）免疫组织化学亚型与术前乳腺磁共振成像（MRI）的形态和半定量动力学分析之间的相关性。具体来说，我们旨在评估三阴性乳腺癌（TNBC）与其他 BC 亚型（非 TNBC）相比的 MRI 特征。
纳入接受乳腺 MRI 检查且随后经核心针活检诊断为 BC 的患者。研究了 MRI 的形态和动力学特征。适当使用参数和非参数检验。
共纳入 75 例 BC 患者，其中 30 例患者为 TNBC 组，45 例患者为非 TNBC 组。与非 TNBC 组相比，我们发现 TNBC 组的病变平均大小更大（P <0.001），边缘增强成像（P=0.003）和 T2 加权图像上的肿瘤内信号强度更高（P=0.03）。与非 TNBC 组相比，我们注意到 TNBC 患者的 BPE 分级较低（P<0.02）。TNBC 组的 EPeak 值较低（P=0.003），SER 值较高（P=0.02）。此外，根据肿瘤分级对动力学参数进行分层，TNBC 组的肿瘤分级（G3）较高（P<0.005），与肿瘤分级较低（G1 和 G2）的 TNBC 相比，该亚组的 SER 值较高（P=0.03）。
经过大规模研究验证后，动态对比增强 MRI 的形态和半定量动力学分析可能有助于 TNBC 患者的术前风险分层，并为基于证据的临床决策提供支持。
