Matthias Dietzel MD, Presenter: Nothing to Disclose

Pascal Andreas Thomas Baltzer MD, Abstract Co-Author: Nothing to Disclose

Ramy Zoubi, Abstract Co-Author: Nothing to Disclose

Charlotte Jerowski, Abstract Co-Author: Nothing to Disclose

Hartmut Peter Burmeister MD, Abstract Co-Author: Nothing to Disclose

Oumar Camara, Abstract Co-Author: Nothing to Disclose

Werner Alois Kaiser MD, PhD, Abstract Co-Author: Researcher, Siemens AG Researcher, Bayer AG Researcher, General Electric Company Researcher, Suros Surgical Systems, Inc Researcher, C. R. Bard, Inc Researcher, Boston Scientific Corporation Researcher, Galil Medical Ltd Researcher, Koninklijke Philips Electronics NV Researcher, Confirma, Inc Researcher, CAD Sciences LLC Researcher, Carl Zeiss Stiftung

There is increasing data, suggesting that breast MRI provides not only diagnostic but also prognostic information. Nevertheless, the potential incremental value of this breast imaging technique compared to classical prognostic factors has not been evaluated, yet. Accordingly, this study aims to systematically investigate the potential of classical prognostic factors alone and in combination with breast MRI to predict occurrence of distant metastasis.

350 consecutive patients with newly diagnosed invasive breast cancer received pretherapeutic breast MRI examination at 1.5 Tesla according to international guidelines. All patients were followed up according to national guidelines and occurrence of distant metastasis was documented. For breast MRI analysis, dedicated commercial CAD (computer assisted diagnosis) software was used. It allowed semiautomatic quantitative measurement of typical enhancement parameters of the Initial- and Intermediate/Late Phase. In all patients classical prognostic factors were determined including nodal status, T-stage, typing, grading, additional in situ components, steroid receptors and herceptin score. Binary logistic regression was used to assess accuracy of [a] clinical factors alone and [b] in combination with CAD to predict occurrences of distant metastases (AUC: Area under the receiver operating characteristics curve; AUC-comparision).

During follow-up 47 patients were diagnosed with metachronous distant metastasis (mean age: 57 years; range: 27-87 years). Median follow-up time was 56 months. Clinical factors alone showed a good accuracy to predict distant metastases (AUC=0,809). Yet, additional use of CAD derived enhancement parameters of breast MRI significantly increased this value by 0,055 (AUC=0,864; P<0,05).

Computer assisted evaluation of enhancement parameters in breast MRI provides functional information. According to our initial data, it adds significant incremental value to classical prognostic factors.

Breast MRI provides prognostic data, adding significant incremental to classical prognostic factors. Such data could be used to further optimize individual therapeutic management.

Dietzel, M, Baltzer, P, Zoubi, R, Jerowski, C, Burmeister, H, Camara, O, Kaiser, W, Breast MRI as a Potential Biomarker to Predict Occurrence of Distance Metastasis: Is There Any Incremental Value Compared to Classical Prognostic Factors?.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11034646.html