Original Research

Feasibility analysis of early temporal kinetics as a surrogate marker for breast tumor type, grade, and aggressiveness

Corresponding Author

Laura Heacock MD

[email protected]

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Address reprint requests to: L.H., Department of Radiology, New York University School of Medicine, 550 First Ave., New York, NY, 10016. E-mail: [email protected]Search for more papers by this author

Alana A. Lewin MD,

Alana A. Lewin MD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

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Yiming Gao MD,

Yiming Gao MD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

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James S. Babb PhD,

James S. Babb PhD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

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Samantha L. Heller PhD, MD,

Samantha L. Heller PhD, MD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

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Amy N. Melsaether MD,

Amy N. Melsaether MD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Center for Advanced Imaging Innovation and Research (CAI² R), New York University School of Medicine, New York, New York, USA

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Neeti Bagadiya MD,

Neeti Bagadiya MD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

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Sungheon G. Kim PhD,

Sungheon G. Kim PhD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Center for Advanced Imaging Innovation and Research (CAI² R), New York University School of Medicine, New York, New York, USA

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Linda Moy MD,

Linda Moy MD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Center for Advanced Imaging Innovation and Research (CAI² R), New York University School of Medicine, New York, New York, USA

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Laura Heacock MD,

Corresponding Author

Laura Heacock MD

[email protected]

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Address reprint requests to: L.H., Department of Radiology, New York University School of Medicine, 550 First Ave., New York, NY, 10016. E-mail: [email protected]Search for more papers by this author

Alana A. Lewin MD,

Alana A. Lewin MD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Search for more papers by this author

Yiming Gao MD,

Yiming Gao MD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Search for more papers by this author

James S. Babb PhD,

James S. Babb PhD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

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Samantha L. Heller PhD, MD,

Samantha L. Heller PhD, MD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

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Amy N. Melsaether MD,

Amy N. Melsaether MD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Center for Advanced Imaging Innovation and Research (CAI² R), New York University School of Medicine, New York, New York, USA

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Neeti Bagadiya MD,

Neeti Bagadiya MD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Search for more papers by this author

Sungheon G. Kim PhD,

Sungheon G. Kim PhD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Center for Advanced Imaging Innovation and Research (CAI² R), New York University School of Medicine, New York, New York, USA

Search for more papers by this author

Linda Moy MD,

Linda Moy MD

Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA

Center for Advanced Imaging Innovation and Research (CAI² R), New York University School of Medicine, New York, New York, USA

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First published: 27 November 2017

https://doi.org/10.1002/jmri.25897

Citations: 12

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Abstract

Background

Screening breast MRI has been shown to preferentially detect high-grade ductal carcinoma in situ (DCIS) and invasive carcinoma, likely due to increased angiogenesis resulting in early initial uptake of contrast. As interest grows in abbreviated screening breast MRI (AB-MRI), markers of early contrast washin that can predict tumor grade and potential aggressiveness are of clinical interest.

Purpose

To evaluate the feasibility of using the initial enhancement ratio (IER) as a surrogate marker for tumor grade, hormone receptor status, and prognostic markers, as an initial step to being incorporated into AB-MRI.

Study Type

Retrospective.

Subjects

In all, 162 women (mean 55.0 years, range 32.8–87.7 years) with 187 malignancies imaged January 2012–November 2015.

Field Strength/Sequence

Images were acquired at 3.0T with a T₁-weighted gradient echo fat-suppressed-volume interpolated breath-hold sequence.

Assessment

Subjects underwent dynamic contrast-enhanced breast MRI with a 7-channel breast coil. IER (% signal increase over baseline at the first postcontrast acquisition) was assessed and correlated with background parenchymal enhancement, washout curves, stage, and final pathology.

Statistical Tests

Chi-square test, Spearman rank correlation, Mann–Whitney U-tests, Bland–Altman analysis, and receiver operating characteristic curve analysis.

Results

IER was higher for invasive cancer than for DCIS (R1/R2, P < 0.001). IER increased with tumor grade (R1: r = 0.56, P < 0.001, R2: r = 0.50, P < 0.001), as ki-67 increased (R1: r = 0.35, P < 0.001; R2 r = 0.35, P < 0.001), and for node-positive disease (R1/R2, P = 0.001). IER was higher for human epidermal growth factor receptor two-positive and triple negative cancers than for estrogen receptor-positive / progesterone receptor-positive tumors (R1 P < 0.001–0.002; R2 P = 0.0.001–0.011). IER had higher sensitivity (80.6% vs. 75.5%) and specificity (55.8% vs. 48.1%) than washout curves for positive nodes, higher specificity (48.1% vs. 36.5%) and positive predictive value (70.2% vs. 66.7%) for high ki-67, and excellent interobserver agreement (intraclass correlation coefficient = 0.82).

Data Conclusion

IER, a measurement of early contrast washin, is associated with higher-grade malignancies and tumor aggressiveness and might be potentially incorporated into an AB-MRI protocol.

Level of Evidence: 3

Technical Efficacy: Stage 2

J. Magn. Reson. Imaging 2018;47:1692–1700.

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Citing Literature

Volume47, Issue6

June 2018

Pages 1692-1700

Feasibility analysis of early temporal kinetics as a surrogate marker for breast tumor type, grade, and aggressiveness

Abstract

Background

Purpose

Study Type

Subjects

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

References

Citing Literature

References

Information

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Feasibility analysis of early temporal kinetics as a surrogate marker for breast tumor type, grade, and aggressiveness

Abstract

Background

Purpose

Study Type

Subjects

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

References

Citing Literature

References

Related

Information