MRI phenotype of breast cancer: Kinetic assessment for molecular subtypes

J Magn Reson Imaging. 2015 Oct;42(4):920-4. doi: 10.1002/jmri.24884. Epub 2015 Mar 9.

Abstract

Purpose: To evaluate the dynamic contrast-enhanced magnetic resonance imaging (MRI) kinetic characteristics of newly diagnosed breast cancer molecular subtypes.

Materials and methods: Breast MRI examinations of 112 patients with newly diagnosed breast cancer were reviewed. Cases of newly diagnosed invasive ductal carcinoma were sorted by molecular subtype (28 TN, 11 HER2 +, 73 Lum A/B) and MRI field strength, with lesion segmentation and kinetic analyses performed on a dedicated workstation. For kinetic assessment, 50% and 100% thresholds were employed for display of medium and rapid uptake. Kinetic profiles in terms of percent volume for six kinetic types (medium-persistent, medium-plateau, medium-washout, fast-persistent, fast-plateau, fast-washout) relative to the whole volume of the lesion were obtained. Statistical analysis of the kinetic profiles was performed using Welch's t-test.

Results: Percent volume of HER2-positive lesions with >100% uptake at early phase on 3T strength MRI exams was significantly greater compared with luminal A/B (93.8 ± 0.92 vs. 77.3 ± 7.2; P < 0.01) and triple negative (93.8 ± 0.92 vs. 81.3 ± 8.2; P < 0.05) subtypes. The >50% early phase uptake for HER2+ lesions was also higher than Lum A/B (99.1 ± 0.73 vs. 93.6 ± 3.05; P < 0.01) at 3T. In the 1.5T subgroup the percent volume of HER2+ tumors with >50% and >100% early phase uptake trended higher than Lum A/B lesions without reaching significance.

Conclusion: The percent volume of HER2-positive tumors demonstrating rapid early contrast uptake is significantly increased compared to other molecular subtypes.

Keywords: HER2; breast cancer; dynamic contrast MRI; luminal A/B; triple negative.

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / metabolism*
  • Breast Neoplasms / pathology*
  • Carcinoma, Ductal, Breast / metabolism
  • Carcinoma, Ductal, Breast / pathology*
  • Computer Simulation
  • Contrast Media / pharmacokinetics
  • Female
  • Gadolinium DTPA / pharmacokinetics*
  • Humans
  • Image Interpretation, Computer-Assisted / methods
  • Kinetics
  • Magnetic Resonance Imaging / methods*
  • Metabolic Clearance Rate
  • Middle Aged
  • Models, Biological
  • Phenotype
  • Precision Medicine / methods
  • Receptor, ErbB-2 / metabolism*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Young Adult

Substances

  • Contrast Media
  • gadodiamide
  • Receptor, ErbB-2
  • Gadolinium DTPA