Evaluating the Relationship Between Dynamic Contrast‐Enhanced MRI (DCE‐MRI) Parameters and Pathological Characteristics in Breast Cancer

Background Dynamic contrast‐enhanced MRI (DCE‐MRI) is used to evaluate tumor microvasculature. However, studies demonstrating an association between perfusion parameters derived from DCE‐MRI and histopathologic characteristics are limited to a small set of histopathologic factors, and the results are inconsistent. Purpose To evaluate the relationship between DCE‐MRI perfusion parameters and common histopathologic tumor characteristics used to predict angiogenesis and determine prognosis in breast cancer. Study Type Retrospective. Population In all, 105 breast cancer patients with invasive ductal carcinoma (122 lesions). Field Strength/Sequence 3.0T, turbo spin‐echo ( TSE ) T 1 ‐weighted, fat‐suppressed T 2 ‐weighted, TSE T 2 ‐weighted, and dynamic unenhanced and contrast‐enhanced 3D T 1 high‐resolution isotropic volume examination. Assessment One reviewer obtained perfusion parameters (K trans , k ep , v e , and v p ) of each breast cancer from DCE MRI using the extended Tofts model with a fixed baseline T 1 value and a population‐based arterial input function. The relationship between DCE‐MRI perfusion parameters and histopathologic tumor characteristics used to predict angiogenesis and determine prognosis was evaluated. Statistical Tests Student's t ‐test, Mann–Whitney U ‐test, analysis of variance (ANOVA), and Kruskal–Wallis test were used. Results Triple‐negative breast cancers exhibited higher K trans and k ep than luminal cancers ( P < 0.05). Estrogen receptor (ER)‐negative tumors showed higher K trans than ER‐positive tumors ( P < 0.05). Progesterone receptor (PR)‐negative tumors presented higher v e than PR‐positive tumors ( P < 0.05). Tumors with higher Ki‐67 showed higher k ep than tumors with lower Ki‐67 ( P < 0.05). P53‐positive tumors exhibited higher K trans and k ep than p53‐negative tumors ( P < 0.05). Higher histologic grade tumors (grade II/III) presented higher K trans , k ep , v p ( P < 0.05) than grade I tumors. Tumors with LVSI presented higher K trans and k ep than tumors without LVSI ( P < 0.05). Data Conclusion Breast cancer presenting higher K trans and k ep on DCE‐MRI was associated with poor prognostic histopathologic factors. Therefore, pretreatment DCE‐MRI perfusion parameters may be useful imaging biomarkers for the evaluation of tumor prognosis and angiogenesis. Level of Evidence 3 Technical Efficacy Stage 2