Zhang Michelle, Sadinski Meredith, Haddad Dana, Bae Min Sun, Martinez Danny, Morris Elizabeth A, Gibbs Peter, Sutton Elizabeth J
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States.
Department of Radiology, McGill University, Montreal, QC, Canada.
Front Oncol. 2021 Feb 4;10:595820. doi: 10.3389/fonc.2020.595820. eCollection 2020.
Breast MRI background parenchymal enhancement (BPE) can potentially serve as a prognostic marker, by possible correlation with molecular subtype. Oncotype Dx, a gene assay, is a prognostic and predictive surrogate for tumor aggressiveness and treatment response. The purpose of this study was to investigate the association between contralateral non-tumor breast magnetic resonance imaging (MRI) background parenchymal enhancement and tumor oncotype score.
In this retrospective study, patients with ER+ and HER2- early stage invasive ductal carcinoma who underwent preoperative breast MRI, oncotype risk scoring, and breast conservation surgery from 2008-2010 were identified. After registration, BPE from the pre and three post-contrast phases was automatically extracted using a k-means clustering algorithm. Four metrics were calculated: initial enhancement (IE) relative to the pre-contrast signal, late enhancement, overall enhancement (OE), and area under the enhancement curve (AUC). Histogram analysis was performed to determine first order metrics which were compared to oncotype risk score groups using Mann-Whitney tests and Spearman rank correlation analysis.
This study included 80 women (mean age = 51.1 ± 10.3 years); 46 women were categorized as low risk (≤17) and 34 women were categorized as intermediate/high risk (≥18) according to Oncotype Dx. For the mean of the top 10% pixels, significant differences were noted for IE (p = 0.032), OE (p = 0.049), and AUC (p = 0.044). Using the risk score as a continuous variable, correlation analysis revealed a weak but significant correlation with the mean of the top 10% pixels for IE (r = 0.26, p = 0.02), OE (r = 0.25, p = 0.02), and AUC (r = 0.27, p = 0.02).
BPE metrics of enhancement in the non-tumor breast are associated with tumor Oncotype Dx recurrence score, suggesting that the breast microenvironment may relate to likelihood of recurrence and magnitude of chemotherapy benefit.
乳腺磁共振成像（MRI）背景实质强化（BPE）可能与分子亚型相关，从而有可能作为一种预后标志物。Oncotype Dx基因检测是肿瘤侵袭性和治疗反应的一种预后及预测替代指标。本研究的目的是调查对侧非肿瘤乳腺磁共振成像（MRI）背景实质强化与肿瘤Oncotype评分之间的关联。
在这项回顾性研究中，确定了2008年至2010年间接受术前乳腺MRI、Oncotype风险评分及保乳手术的雌激素受体阳性（ER+）和人表皮生长因子受体2阴性（HER2-）早期浸润性导管癌患者。登记后，使用k均值聚类算法自动提取造影前及造影后三个阶段的BPE。计算了四个指标：相对于造影前信号的初始强化（IE）、延迟强化、总体强化（OE）以及强化曲线下面积（AUC）。进行直方图分析以确定一阶指标，并使用Mann-Whitney检验和Spearman等级相关分析将其与Oncotype风险评分组进行比较。
本研究纳入了80名女性（平均年龄=51.1±10.3岁）；根据Oncotype Dx，46名女性被归类为低风险（≤17），34名女性被归类为中/高风险（≥18）。对于前10%像素的平均值，IE（p=0.032）、OE（p=0.049）和AUC（p=0.044）存在显著差异。将风险评分作为连续变量，相关分析显示IE（r=0.26，p=0.02）、OE（r=0.25，p=0.02）和AUC（r=0.27，p=0.02）与前10%像素的平均值之间存在微弱但显著的相关性。
非肿瘤乳腺的BPE强化指标与肿瘤Oncotype Dx复发评分相关，提示乳腺微环境可能与复发可能性及化疗获益程度有关。
