VALUE OF 3 TESLA PERFUSION MAGNETIC RESONANCE IMAGING IN PREDICTING HISTOLOGYCAL GRADE AND BIOMARKERS EXPRESSION OF BREAST CANCER

Nguyen Tien Phu1, Luu Hong Nhung2, Lai Thu Huong2, Nguyen Cong Tien2, Nguyen Khoi Viet2, Vu Dang Luu2
1 Vinmec Times City International General Hospital
2 Institute of Diagnostic and Interventional Radiology of Bach Mai Hospital

Main Article Content

Abstract

Objective: Analyze the value of perfusion parameters on 3 Tesla magnetic resonance imaging in predicting histological grade, biomarkers expression and molecular classification of invasive ductal breast cancer.


Methods: Cross-sectional descriptive study was conducted on 48 patients with invasive ductal breast cancer undergoing magnetic resonance perfusion imaging at the Institute of Diagnostic and Interventional Radiology of Bach Mai Hospital from January 2022 to June 2024. Measure Ktrans, Kep, Ve, Maxslope, CER parameters, collect results of histopathological diagnosis, immunohistochemical staining, and molecular classification. Descriptive statistical analysis and inferential statistical analysis determined the correlation of perfusion parameters with histological grade and expression of biological markers, molecular classification.


Results: The Kep parameter can discriminate high and low histology grade with an area under the ROC curve of 0.737. The Ktrans, Kep, Ve parameters have the ability to predict the value of the Ki67 index because Ktrans, Kep have a positive linear correlation with Ki67 while Ve has a negative linear correlation with Ki67 with correlation coefficients are +0.438, +0.373 and -0.326 respectively. Ktrans and CER were capable of distinguishing the HER2-enriched molecular subtype from the remaining groups with an area under the ROC curve of 0.74 and 0.72, respectively.


Conclusion: Perfusion parameters on 3 Tesla breast MRI have the ability to predict histology grade and biomarkers expression, molecular classification of invasive ductal breast cancer. Perfusion parameters have the potential to become prognostic factors in breast cancer.

Article Details

References

[1] MRI exam-specific parameters: breast (revised 5/2/2024). Accreditation support. Accessed October 28, 2024.
[2] Amarnath J, Sangeeta T, Mehta S.B. Role of quantitative pharmacokinetic parameter (transfer constant: Ktrans) in the characterization of breast lesions on MRI. Indian J Radiol Imaging, 2013, 23 (1): 19-25. doi: 10.4103/0971-3026.113614
[3] Kang S.R, Kim H.W, Kim H.S. Evaluating the relationship between dynamic contrast-enhanced MRI (DCE-MRI) parameters and pathological characteristics in breast cancer. Journal of Magnetic Resonance Imaging, 2020, 52 (5): 1360-1373. doi: 10.1002/jmri.27241
[4] Thakran S, Gupta P.K, Kabra V et al. Characterization of breast lesion using T1-perfusion magnetic resonance imaging: qualitative vs. quantitative analysis. Diagnostic and Interventional Imaging, 2018, 99 (10): 633-642. doi: 10.1016/j.diii.2018.05.006
[5] Yi B, Kang D.K, Yoon D et al. Is there any correlation between model-based perfusion parameters and model-free parameters of time-signal intensity curve on dynamic contrast enhanced MRI in breast cancer patients? Eur Radiol, 2014, 24 (5): 1089-1096. doi: 10.1007/s00330-014-3100-6
[6] Liu L, Mei N, Yin B, Peng W. Correlation of DCE-MRI perfusion parameters and molecular biology of breast infiltrating ductal carcinoma. Front Oncol, 2021, 11: 561735. doi: 10.3389/fonc.2021.561735
[7] Uncu U.Y, Aydin Aksu S. Correlation of perfusion metrics with Ki-67 proliferation index and axillary involvement as a prognostic marker in breast carcinoma cases: a dynamic contrast-enhanced perfusion MRI study. Diagnostics (Basel), 2023, 13 (20): 3260. doi: 10.3390/diagnostics13203260
[8] Travis R.C, Key T.J. Oestrogen exposure and breast cancer risk. Breast Cancer Research: BCR, 2003, 5 (5): 239. doi: 10.1186/bcr628
[9] Li X, Fu P, Jiang M et al. The diagnostic performance of dynamic contrast-enhanced MRI and its correlation with subtypes of breast cancer. Medicine, 2021, 100 (51): e28109. doi: 10.1097/MD.0000000000028109
[10] Surov A, Kim J.Y, Aiello M et al. Associations between dynamic contrast enhanced magnetic resonance imaging and clinically relevant histopathological features in breast cancer: a multicenter analysis. In Vivo, 2022, 36 (1): 398. doi: 10.21873/invivo.12717
[11] Du S, Gao S, Zhang L, Yang X, Qi X, Li S. Improved discrimination of molecular subtypes in invasive breast cancer: comparison of multiple quantitative parameters from breast MRI. Magnetic Resonance Imaging, 2021, 77: 148-158. doi: 10.1016/j.mri.2020.12.001
[12] Koo H.R, Cho N, Song I.C et al. Correlation of perfusion parameters on dynamic contrast‐enhanced MRI with prognostic factors and subtypes of breast cancers. Magnetic Resonance Imaging, 2012, 36 (1): 145-151. doi: 10.1002/jmri.23635.