title: Does hypervascularity of liver metastases as detected on MRI predict disease progression in breast cancer patients?
abstract: OBJECTIVE
  The aim of our study was to evaluate the association of the vascularity of liver metastases, as characterized by MRI, and disease progression in breast cancer patients.
  
  
  METHODS
  Sixteen breast cancer patients with liver metastases who underwent MRI before and after systemic therapy were retrospectively identified. On the basis of comparison of each MRI examination with the previous examination, disease status of the patients was classified as complete response, partial response, stable disease, or progressive disease. Liver metastases were characterized as hyper- or hypovascular on the basis of the degree of enhancement in the arterial, portal, and interstitial phases of imaging after administration of a contrast agent. Fisher's exact test and ordinal logistic regression models, including the type of systemic therapy, presence of multiple metastases, and hormone receptor status, were used to estimate the unadjusted and risk-adjusted association between the presence of hypervascular liver metastases and disease progression.
  
  
  RESULTS
  All patients in our sample (n = 16) were women and most (12/16, 75%) were white. Their median age was 51.5 years. In unadjusted analyses, the association between the presence of hypervascular liver metastases and disease progression was statistically significant (p < 0.0001). In multiple logistic regression analyses, hypervascular liver metastases were found to be an independent predictor of disease progression. Patients with hypervascular liver lesions were 20.5 times more likely to experience disease progression than patients without hypervascular metastases (odds ratio, 20.5; 95% confidence interval, 5.1-83.5; p < 0.0001).
  
  
  CONCLUSIONS
  Our analysis provides suggestive evidence that disease progression can be predicted through MRI assessment of the vascularity of liver metastases in patients with breast cancer.
authors.affiliation: Department of Radiology, University of North Carolina at Chapel Hill, Manning Dr, Chapel Hill, NC 27599-7510, USA.
authors.forename: Larissa
authors.initials: L
authors.lastname: Braga
authors.forename: Richard C
authors.initials: RC
authors.lastname: Semelka
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pietrobon
authors.forename: Diego
authors.initials: D
authors.lastname: Martin
authors.forename: Nestor
authors.initials: N
authors.lastname: de Barros
authors.forename: Ulrich
authors.initials: U
authors.lastname: Guller
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology*; D044584:Carcinoma, Ductal / Q000098:blood supply* / Q000473:pathology / Q000556:secondary*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply* / Q000473:pathology / Q000556:secondary*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies