Rationale and Objectives
The study aimed to investigate whether intravoxel incoherent motion (IVIM) and dynamic
contrast-enhanced (DCE) magnetic resonance imaging (MRI) can differentiate luminal-B
from luminal-A breast cancer
Materials and Methods
Biexponential analyses of IVIM and DCE MRI were performed using a 3.0-T MRI scanner,
involving 134 patients with 137 pathologically confirmed luminal-type invasive breast
cancers. Luminal-type breast cancer was categorized as luminal-B breast cancer (LBBC,
Ki-67 ≧ 14%) or luminal-A breast cancer (LABC, Ki-67 < 14%). Quantitative parameters
from IVIM (pure diffusion coefficient [D], perfusion-related diffusion coefficient
[D*], and fraction [f]) and DCE MRI (initial percentage of enhancement and signal
enhancement ratio [SER]) were calculated. The apparent diffusion coefficient (ADC)
was also calculated using monoexponential fitting. We correlated these data with the
Ki-67 status.
Results
The D and ADC values of LBBC were significantly lower than those of LABC (P = 0.028, P = 0.037). The SER of LBBC was significantly higher than that of LABC (P = 0.004). A univariate analysis showed that a significantly lower D (<0.847 x 10−3 mm2/s), lower ADC (<0.960 × 10−3 mm2/s), and higher SER (>1.071) values were associated with LBBC (all P values <0.01), compared to LABC. In a multivariate analysis, a higher SER (>1.071;
odds ratio: 3.0099, 95% confidence interval: 1.4246–6.3593; P = 0.003) value and a lower D (<0.847 × 10−3 mm2/s; odds ratio: 2.6878, 95% confidence interval: 1.0445–6.9162; P = 0.040) value were significantly associated with LBBC, compared to LABC.
Conclusion
The SER derived from DCE MRI and the D derived from IVIM are associated independently
with the Ki-67 status in patients with luminal-type breast cancer.
Key Words
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References
- Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications.Proc Natl Acad Sci USA. 2001; 98: 10869-10874
- A gene expression signature as a predictor of survival in breast cancer.N Engl J Med. 2002; 347: 1999-2009
- Biological processes associated with breast cancer clinical outcome depend on the molecular subtypes.Clin Cancer Res. 2008; 14: 5158-5165
- Breast cancer molecular subtypes respond differently to preoperative chemotherapy.Clin Cancer Res. 2005; 11: 5678-5685
- Immunohistochemically defined subtypes and outcome in occult breast carcinoma with axillary presentation.Breast Cancer Res Treat. 2011; 129: 867-875
- Ki67 index, HER2 status, and prognosis of patients with luminal B breast cancer.J Natl Cancer Inst. 2009; 101: 736-750
- Tumour molecular subtyping according to hormone receptors and HER2 status defines different pathological complete response to neoadjuvant chemotherapy in patients with locally advanced breast cancer.Clin Transl Oncol. 2008; 10: 646-653
- Strategies for subtypes: dealing with the diversity of breast cancer—highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer.Ann Oncol. 2011; 22: 1736-1747
- Personalizing the treatment of woman with early breast cancer—highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer.Ann Oncol. 2013; 24: 2206-2223
- Correlation between Ki67 and breast cancer prognosis.Oncology. 2013; 84: 219-225
- Expression of ER, PgR, HER1, HER2, and response: a study of preoperative chemotherapy.Ann Oncol. 2008; 19: 465-472
- Ki67 in breast cancer: prognostic and predictive potential.Lancet Oncol. 2010; 11: 174-183
- Assessment of Ki67 in breast cancer: recommendations from the International Ki67 in Breast Cancer working group.J Natl Cancer Inst. 2011; 103: 1656-1664
- Differentiation of clinically benign and malignant breast lesions using diffusion-weighted imaging.J Magn Reson Imaging. 2002; 16: 172-178
- Diffusion-weighted imaging of breast cancer: correlation of the apparent diffusion coefficient value with prognostic factors.J Magn Reson Imaging. 2009; 30: 615-620
- Correlations between diffusion-weighted imaging and breast cancer biomarkers.Eur Radiol. 2012; 22: 1519-1528
- Triple-negative breast cancer on dynamic contrast-enhanced and diffusion-weighted MR imaging: comparison with other breast cancer subtypes.Eur Radiol. 2012; 22: 1724-1734
- Correlations between apparent diffusion coefficient values of invasive ductal carcinoma and pathologic factors on diffusion-weighted MRI at 3.0 tesla.J Magn Reson Imaging. 2015; 41: 175-182
- Luminal-type breast cancer: correlation of apparent diffusion coefficients with the Ki-67 labeling index.Radiology. 2014; 274: 66-73
- MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurologic disorders.Radiology. 1986; 161: 401-407
- Biexponential signal attenuation analysis of diffusion-weighted imaging of breast.Magn Reson Med Sci. 2010; 9: 195-207
- Intravoxel incoherent motion imaging of tumor microenvironment in locally advanced breast cancer.Magn Reson Med. 2011; 65: 1437-1447
- Intravoxel incoherent motion (IVIM) in evaluation of breast lesions: comparison with conventional DWI.Eur J Radiol. 2013; 82: e782-e789
- Intravoxel incoherent motion diffusion-weighted MRI at 3.0 T differentiates malignant breast lesions from benign lesions and breast parenchyma.J Magn Reson Imaging. 2014; 40: 813-823
- Intravoxel incoherent motion MR imaging for breast lesions: comparison and correlation with pharmacokinetic evaluation from dynamic contrast-enhanced MR imaging.Eur Radiol. 2016; 26: 3888-3898https://doi.org/10.1007/s00330-016-4241-6
- Intravoxel incoherent motion diffusion-weighted imaging as an adjunct to dynamic contrast-enhanced MRI to improve accuracy of the differential diagnosis of benign and malignant breast lesions.Magn Reson Imaging. 2017; 36: 175-179
- Intravoxel incoherent motion (IVIM)-derived parameters in diffusion-weighted MRI: associations with prognostic factors in invasive ductal carcinoma.J Magn Reson Imaging. 2017; 45: 1394-1406
- Intravoxel incoherent motion diffusion-weighted MR imaging of breast cancer: association with histopathological features and subtypes.Br J Radiol. 2016; 89: 20160140https://doi.org/10.1259/bjr.20160140
- Evaluation of breast cancer using intravoxel incoherent motion (IVIM) histogram analysis: comparison with malignant status, histological subtype, and molecular prognostic factors.Eur Radiol. 2016; 26: 2547-2558
- Diagnosis of cirrhosis with intravoxel incoherent motion diffusion MRI and dynamic contrast-enhanced MRI alone and in combination: preliminary experience.J Magn Reson Imaging. 2010; 31: 589-600
- Modified triexponential analysis of intravoxel incoherent motion for brain perfusion and diffusion.J Magn Reson Imaging. 2016; 43: 818-823
- Semi-automated analysis for MRI of breast tumors.Stud Health Technol Inform. 1999; 62: 259-260
- Differences in morphological features and minimum apparent diffusion coefficient values among breast cancer subtypes using 3-tesla MRI.Eur J Radiol. 2016; 85: 96-102
- Dynamic contrast-enhanced and diffusion-weighted MRI of estrogen receptor-positive invasive breast cancers: associations between quantitative MR parameters and Ki-67 proliferation status.J Magn Reson Imaging. 2016; 45: 94-102https://doi.org/10.1002/jmri.25348
- Suspect breast lesions: findings at dynamic gadolinium-enhanced MR imaging correlated with mammographic and pathologic features.Radiology. 1995; 197: 387-395
- Prognostic value of contrast-enhanced MR mammography in patients with breast cancer.Eur Radiol. 1997; 7: 1002-1005
- Correlation between high resolution dynamic MR features and prognostic factors in breast cancer.Korean J Radiol. 2008; 9: 10-18
- Correlation of perfusion parameters on dynamic contrast-enhanced MRI with prognostic factors and subtypes of breast cancers.J Magn Reson Imaging. 2012; 36: 145-151
- Enhancement parameters on dynamic contrast enhanced breast MRI: do they correlate with prognostic factors and subtypes of breast cancers?.Magn Reson Imaging. 2015; 33: 72-80
- Perfusion parameters in dynamic contrast-enhanced MRI and apparent diffusion coefficient value in diffusion-weighted: association with prognostic factors in breast cancer.Acad Radiol. 2016; 23: 446-456
Article Info
Publication History
Published online: August 01, 2017
Accepted:
June 19,
2017
Received in revised form:
June 17,
2017
Received:
January 4,
2017
Identification
Copyright
© 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
