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Yamaguchi K, Nakazono T, Egashira R, Fukui S, Baba K, Hamamoto T, Irie H. Maximum slope of ultrafast dynamic contrast-enhanced MRI of the breast: Comparisons with prognostic factors of breast cancer. Jpn J Radiol 2020; 39:246-253. [PMID: 33001328 DOI: 10.1007/s11604-020-01049-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 09/23/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To determine the relationship between the maximum slope (MS) of ultrafast dynamic contrast-enhanced (DCE)-MRI and prognostic factors of breast cancer. METHODS One hundred thirteen patients with 118 breast cancers were included in this study. The ultrafast DCE sequence was acquired using a higher parallel imaging factor. Its spatial resolution was 0.9 × 0.9 × 2.5 mm and its temporal resolution was 8.3 s/phase. Each lesion was automatically segmented, and the ROI of highest enhancement in the lesion was identified. In this ROI, the MS was calculated. The MS of each lesion was compared with various prognostic factors of breast cancer. RESULTS The MS of invasive cancer (median: 9.81%/sec) was significantly higher than that of ductal carcinoma in situ (median: 7.26%/sec) (p = 0.001). In the ROC analysis, the area under the ROC curve (AUC) was 0.7295. The MS of invasive cancer with axillary lymph node (LN) metastasis (median: 11.97%/sec) was significantly higher than that without axillary LN metastasis (median: 9.425%/sec) (p = 0.0024). In the ROC analysis, the AUC was 0.7177. In addition, the MS became significantly higher as the level of the proliferation marker ki-67 increased (correlation coefficient: 0.3317) (p = 0.0009). CONCLUSIONS MS of ultrafast DCE-MRI is useful for predicting the prognostic factors of breast cancer. Higher maximum slope (MS) is significantly associated with an invasive breast cancer component. Higher MS is significantly associated with an axillary lymph node metastasis. MS becomes significantly higher with increasing ki-67 (a proliferation marker). Ultrafast MRI is useful for predicting the prognostic factors of breast cancer.
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Affiliation(s)
- Ken Yamaguchi
- Department of Radiology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
| | - Takahiko Nakazono
- Department of Radiology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Ryoko Egashira
- Department of Radiology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Shuichi Fukui
- Department of Radiology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | - Koichi Baba
- Department of Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
| | | | - Hiroyuki Irie
- Department of Radiology, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
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Dogan BE, Menezes GLG, Butler RS, Neuschler EI, Aitchison R, Lavin PT, Tucker FL, Grobmyer SR, Otto PM, Stavros AT. Optoacoustic Imaging and Gray-Scale US Features of Breast Cancers: Correlation with Molecular Subtypes. Radiology 2019; 292:564-572. [PMID: 31287388 DOI: 10.1148/radiol.2019182071] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background Optoacoustic imaging can assess tumor hypoxia coregistered with US gray-scale images. The combination of optoacoustic imaging and US may have a role in distinguishing breast cancer molecular subtypes. Purpose To investigate whether optoacoustic US feature scores correlate with breast cancer molecular subtypes. Materials and Methods A total of 1972 women (with a total of 2055 breast masses) underwent prebiopsy optoacoustic US in a prospective multi-institutional study between December 2012 and September 2015. Seven readers blinded to pathologic diagnosis scored gray-scale US and optoacoustic US features of the known cancers. Optoacoustic US features within (internal) and outside of the tumor boundary (external) were scored. Immunohistochemistry findings were obtained from pathology reports. Multinomial logistic regression analysis was used to fit the US scores, adding optoacoustic US features to the model to investigate the incremental benefit of each feature. Kruskal-Wallis tests were used to analyze the relationship between molecular subtypes and feature scores. Results Among 653 invasive cancers identified in 629 women, a total of 532 cancers in 519 women, all of which had molecular markers available, were included in the analysis. Mean age ± standard deviation was 57.9 years ± 12.6. Mean total external optoacoustic US feature scores of luminal (A and B) breast cancers were higher (9.9 vs 8.8; P < .05) and total internal scores were lower (6.8 vs 7.7; P < .001) than those of triple-negative and human epidermal growth factor receptor 2-positive (HER2+) cancers. A multinomial logistic regression model showed that optoacoustic internal vessel (odds ratio [OR], 0.6; 95% confidence interval [CI]: 0.5, 0.8; P = .002), optoacoustic internal blush (OR, 0.7; 95% CI: 0.5, 0.9; P = .02), and optoacoustic internal hemoglobin (OR, 0.6; 95% CI: 0.5, 0.8; P = .001) were associated with classification of luminal versus triple-negative and HER2+ cancer subtypes. Conclusion Combined optoacoustic US imaging and gray-scale US features may help distinguish luminal breast cancers from triple-negative and human epidermal growth factor receptor 2-positive cancers. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Mann in this issue.
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Affiliation(s)
- Basak E Dogan
- From the Department of Diagnostic Radiology, The University of Texas Southwestern Medical Center, 2201 Inwood Rd, Dallas, TX 75390-8585 (B.E.D.); Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX (G.L.G.M., P.M.O., A.T.S.); Seno Medical Instruments, San Antonio, TX (G.L.G.M., A.T.S.); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT (R.S.B.); Department of Radiology, Assistant Professor, Northwestern University Feinberg School of Medicine, Chicago, IL (E.I.N.); Boston Biostatistics Research Foundation, Boston, MA (R.A., P.T.L); Virginia Biomedical Laboratories, LLC, Wirtz, VA (F.L.T.); and Department of Surgical Oncology, Cleveland Clinic, Cleveland, OH (S.R.G.)
| | - Gisela L G Menezes
- From the Department of Diagnostic Radiology, The University of Texas Southwestern Medical Center, 2201 Inwood Rd, Dallas, TX 75390-8585 (B.E.D.); Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX (G.L.G.M., P.M.O., A.T.S.); Seno Medical Instruments, San Antonio, TX (G.L.G.M., A.T.S.); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT (R.S.B.); Department of Radiology, Assistant Professor, Northwestern University Feinberg School of Medicine, Chicago, IL (E.I.N.); Boston Biostatistics Research Foundation, Boston, MA (R.A., P.T.L); Virginia Biomedical Laboratories, LLC, Wirtz, VA (F.L.T.); and Department of Surgical Oncology, Cleveland Clinic, Cleveland, OH (S.R.G.)
| | - Reni S Butler
- From the Department of Diagnostic Radiology, The University of Texas Southwestern Medical Center, 2201 Inwood Rd, Dallas, TX 75390-8585 (B.E.D.); Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX (G.L.G.M., P.M.O., A.T.S.); Seno Medical Instruments, San Antonio, TX (G.L.G.M., A.T.S.); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT (R.S.B.); Department of Radiology, Assistant Professor, Northwestern University Feinberg School of Medicine, Chicago, IL (E.I.N.); Boston Biostatistics Research Foundation, Boston, MA (R.A., P.T.L); Virginia Biomedical Laboratories, LLC, Wirtz, VA (F.L.T.); and Department of Surgical Oncology, Cleveland Clinic, Cleveland, OH (S.R.G.)
| | - Erin I Neuschler
- From the Department of Diagnostic Radiology, The University of Texas Southwestern Medical Center, 2201 Inwood Rd, Dallas, TX 75390-8585 (B.E.D.); Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX (G.L.G.M., P.M.O., A.T.S.); Seno Medical Instruments, San Antonio, TX (G.L.G.M., A.T.S.); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT (R.S.B.); Department of Radiology, Assistant Professor, Northwestern University Feinberg School of Medicine, Chicago, IL (E.I.N.); Boston Biostatistics Research Foundation, Boston, MA (R.A., P.T.L); Virginia Biomedical Laboratories, LLC, Wirtz, VA (F.L.T.); and Department of Surgical Oncology, Cleveland Clinic, Cleveland, OH (S.R.G.)
| | - Roger Aitchison
- From the Department of Diagnostic Radiology, The University of Texas Southwestern Medical Center, 2201 Inwood Rd, Dallas, TX 75390-8585 (B.E.D.); Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX (G.L.G.M., P.M.O., A.T.S.); Seno Medical Instruments, San Antonio, TX (G.L.G.M., A.T.S.); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT (R.S.B.); Department of Radiology, Assistant Professor, Northwestern University Feinberg School of Medicine, Chicago, IL (E.I.N.); Boston Biostatistics Research Foundation, Boston, MA (R.A., P.T.L); Virginia Biomedical Laboratories, LLC, Wirtz, VA (F.L.T.); and Department of Surgical Oncology, Cleveland Clinic, Cleveland, OH (S.R.G.)
| | - Philip T Lavin
- From the Department of Diagnostic Radiology, The University of Texas Southwestern Medical Center, 2201 Inwood Rd, Dallas, TX 75390-8585 (B.E.D.); Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX (G.L.G.M., P.M.O., A.T.S.); Seno Medical Instruments, San Antonio, TX (G.L.G.M., A.T.S.); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT (R.S.B.); Department of Radiology, Assistant Professor, Northwestern University Feinberg School of Medicine, Chicago, IL (E.I.N.); Boston Biostatistics Research Foundation, Boston, MA (R.A., P.T.L); Virginia Biomedical Laboratories, LLC, Wirtz, VA (F.L.T.); and Department of Surgical Oncology, Cleveland Clinic, Cleveland, OH (S.R.G.)
| | - F Lee Tucker
- From the Department of Diagnostic Radiology, The University of Texas Southwestern Medical Center, 2201 Inwood Rd, Dallas, TX 75390-8585 (B.E.D.); Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX (G.L.G.M., P.M.O., A.T.S.); Seno Medical Instruments, San Antonio, TX (G.L.G.M., A.T.S.); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT (R.S.B.); Department of Radiology, Assistant Professor, Northwestern University Feinberg School of Medicine, Chicago, IL (E.I.N.); Boston Biostatistics Research Foundation, Boston, MA (R.A., P.T.L); Virginia Biomedical Laboratories, LLC, Wirtz, VA (F.L.T.); and Department of Surgical Oncology, Cleveland Clinic, Cleveland, OH (S.R.G.)
| | - Stephen R Grobmyer
- From the Department of Diagnostic Radiology, The University of Texas Southwestern Medical Center, 2201 Inwood Rd, Dallas, TX 75390-8585 (B.E.D.); Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX (G.L.G.M., P.M.O., A.T.S.); Seno Medical Instruments, San Antonio, TX (G.L.G.M., A.T.S.); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT (R.S.B.); Department of Radiology, Assistant Professor, Northwestern University Feinberg School of Medicine, Chicago, IL (E.I.N.); Boston Biostatistics Research Foundation, Boston, MA (R.A., P.T.L); Virginia Biomedical Laboratories, LLC, Wirtz, VA (F.L.T.); and Department of Surgical Oncology, Cleveland Clinic, Cleveland, OH (S.R.G.)
| | - Pamela M Otto
- From the Department of Diagnostic Radiology, The University of Texas Southwestern Medical Center, 2201 Inwood Rd, Dallas, TX 75390-8585 (B.E.D.); Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX (G.L.G.M., P.M.O., A.T.S.); Seno Medical Instruments, San Antonio, TX (G.L.G.M., A.T.S.); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT (R.S.B.); Department of Radiology, Assistant Professor, Northwestern University Feinberg School of Medicine, Chicago, IL (E.I.N.); Boston Biostatistics Research Foundation, Boston, MA (R.A., P.T.L); Virginia Biomedical Laboratories, LLC, Wirtz, VA (F.L.T.); and Department of Surgical Oncology, Cleveland Clinic, Cleveland, OH (S.R.G.)
| | - A Thomas Stavros
- From the Department of Diagnostic Radiology, The University of Texas Southwestern Medical Center, 2201 Inwood Rd, Dallas, TX 75390-8585 (B.E.D.); Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX (G.L.G.M., P.M.O., A.T.S.); Seno Medical Instruments, San Antonio, TX (G.L.G.M., A.T.S.); Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT (R.S.B.); Department of Radiology, Assistant Professor, Northwestern University Feinberg School of Medicine, Chicago, IL (E.I.N.); Boston Biostatistics Research Foundation, Boston, MA (R.A., P.T.L); Virginia Biomedical Laboratories, LLC, Wirtz, VA (F.L.T.); and Department of Surgical Oncology, Cleveland Clinic, Cleveland, OH (S.R.G.)
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