Correlation of DCE-MRI Perfusion Parameters and Molecular Biology of Breast Infiltrating Ductal Carcinoma.

OBJECTIVE

We aimed to investigate the correlation of the perfusion parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with the molecular biological expression of breast infiltrating ductal carcinoma (IDC) in order to guide appropriate therapeutic advice and clinical outcome prediction.

MATERIALS AND METHODS

In a prospective analysis of 67 patients with breast IDC, preoperative DCE-MRI and routine MRI images were obtained. The double-chamber model (extended Tofts model) was employed to calculate the perfusion parameters. Postoperative pathological immunohistochemistry was examined, including human epidermal growth factor receptor 2 (HER-2), estrogen receptor (ER), progesterone receptor (PR), cell nuclear-associated antigen (Ki-67), cytokeratin 5/6 (CK5/6), and epidermal growth factor receptor (EGFR). Statistical analysis was applied to explore the relationship between the perfusion parameters and the molecular biomarkers of breast cancer.

RESULTS

A total of 67 lesions were included in our study. The mean maximum diameter of lesions was 4.48 ± 1.73 cm. Perfusion parameters had no correlation with tumor diameters ( > 0.05). The volume transfer constant ( ) and the rate constant ( ) had positive correlations with Ki-67 ( < 0.05). The plasma volume ratio ( ) had a statistical difference between CK5/6 positivity and CK5/6 negativity. The maximum rising slope (MAX Slope) was higher in HER-2-enriched tumors than that in luminal A or B tumors ( < 0.05). was higher in HER-2-enriched tumors than that in luminal A tumors ( < 0.05). The extravascular extracellular space volume fraction ( ) was higher in triple-negative tumors than that in HER-2-enriched and in luminal A and B tumors ( < 0.05). The time to peak enhancement (TTP) was lower in HER-2-enriched tumors than that in luminal A and B tumors ( < 0.05). Maximum concentration (MAX Conc) was higher in triple-negative tumors than that in luminal B tumors ( < 0.05).

CONCLUSION

DCE-MRI perfusion parameters can behave as a noninvasive tool to assess the molecular biological expression and the molecular subtypes of breast IDC. They may aid in predicting breast IDC invasiveness, metastasis, and prognosis.