Hye Ryoung Koo MD, Presenter: Nothing to Disclose

Nariya Cho MD, Abstract Co-Author: Nothing to Disclose

Woo Kyung Moon MD, Abstract Co-Author: Nothing to Disclose

Jung Min Chang MD, Abstract Co-Author: Nothing to Disclose

Ann Yi MD, Abstract Co-Author: Nothing to Disclose

In Chan Song PhD, Abstract Co-Author: Nothing to Disclose

This study was performed to evaluate whether perfusion parameters, such as a transfer constant (Ktrans), backflow compartmental rate constant (Kep), or extracellular extravascular space (Ve) calculated from DCE-MRI data might correlate with histopathologic prognostic factors of breast cancers.

Between July 2009 and March 2010, 70 patients (mean age, 53.84; range, 33-77 years) with newly diagnosed invasive ductal carcinoma underwent bilateral whole breast DCE-MRI for quantification of perfusion parameters and preoperative staging. A total of 42 phases with a temporal resolution of 11 seconds were obtained using a 3D fast SPGR sequence (TR/TE/FA=3.71ms/1.78ms/20degree, matrix=256x256, FOV=280mm, slice thickness=2mm). Signal intensity-time curves were converted into concentration-time curves through T1 mapping. For each breast tumor, perfusion parameters  based on Toft modeling were obtained through a nonlinear Levenberg-Marquardt least-squares fitting algorithm. Histopathologic prognostic factors including tumor size (T1 vs. others), axillary nodal status (negative metastasis vs. positive), nuclear grade (grade 1&2 vs. 3), histologic grade (grade 1&2 vs. 3), estrogen and progesterone receptors (≤10% vs. >10%), Ki-67 (≤5% vs. >5%), p53 (≤5% vs. >5%), bcl-2(0&1+vs. 2+&3+&4+) and HER2 (1+&2+ vs. 3+) expression were analyzed. Perfusion parameters were compared within each dichotomized histopathologic prognostic factors using independent samples t-test.

Mean Ktrans values were higher in tumors with high nuclear grade (0.900±0.359/min vs. 0.631±0.445, p=0.017), high histologic grade (0.922±0.467/min vs. 0.672±0.443/min, p=0.036), or ER negativity (0.923±0.519/min vs. 0.675±0.404/min, p=0.028) than those with low nuclear grade, low histologic grade, or ER positivity. In addition, mean Ve values were lower in tumors with high nuclear grade (0.582±0.543 vs. 0.997±0.862, p=0.026) or high histologic grade (0.562±0.557 vs. 0.970±0.771, p=0.018). No other correlation was found between perfusion parameters and histopathologic prognostic factors.

Breast cancers with high Ktrans values (vascular permeability) tend to have a high nuclear grade, high histologic grade, or ER negativity suggestive of a poor prognosis than those with low Ktrans values.  

Quantification of hemodynamic parameters derived from DCE-MRI can be useful for in vivo characterization of primary breast cancers.

Koo, H, Cho, N, Moon, W, Chang, J, Yi, A, Song, I, Correlation of Perfusion Parameters on Dynamic Contrast-enhanced MRI (DCE-MRI) with Histopathologic Prognostic Factors of Primary Breast Cancers.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9006697.html