Hepatobiliary phase manifestations of breast cancer liver metastasis: differentiating molecular types through Gd-EOB-DTPA-enhanced MRI.

OBJECTIVE

The primary objective of this study is to evaluate the diagnostic efficacy of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) -enhanced magnetic resonance imaging (MRI) in distinguishing breast cancer liver metastasis (BCLM) across different molecular types.

METHODS

Between August 2014 and July 2021, a cohort of 270 patients histologically diagnosed with BCLM underwent examination through dynamic contrast-enhanced MRI (DCE-MRI). The data collection encompassed clinical information of patients, as well as information on the quantity, shape, boundary, and fusion state of liver metastases. Additionally, MR sequences including T2-weighted imaging with fat suppression (FS), diffusion-weighted imaging (DWI), MR arterial phase, and hepatobiliary phase (HBP) were collected. The chi-squared test was employed to study the correlations between different molecular types of BCLM and imaging features observed in MRI.

RESULTS

Significant differences were observed in the HBP image features among various subtypes of breast cancer (P = 0.022). The morphology (oval, irregular) and fusion state (converging, separated lesions) of BCLM exhibited statistically significant differences based on breast cancer subtypes (P = 0.022, 0.004). No statistical differences were found in the quantity of BCLM, the boundary of metastasis (clear or vague), and imaging features of the T2WI-FS and DWI concerning the molecular subtypes of BCLM (P = 0.693, 0.161, 0.629, 0.629).

CONCLUSION

The findings suggest that MRI, particularly Gd-EOB-DTPA-enhanced MRI, they displayed varied enhancement patterns, including the low signal, "target sign", "rim enhancement", and "doughnut-like enhancement". Most basal-like metastases demonstrated a low signal, the other molecular types primarily showing the "target sign". This is invaluable in the imaging diagnosis of BCLM across different molecular type.

CLINICAL TRIAL NUMBER

Not applicable.