Pharmacokinetic analysis of ductal carcinoma in situ of the breast using dynamic MR mammography.
The purpose of this study was to assess the relationship between functional parameters derived from dynamic MR imaging and the histological findings of breast ductal carcinoma in situ (DCIS) and DCIS with invasive foci, and to evaluate whether these parameters might predict DCIS patient outcome. Two parameters, amplitude A and k(21), were determined from multicompartmental pharmacokinetic analyses of dynamic MR mammography in 39 patients with needle biopsy-proven primary DCIS. After surgery, the histological tumor characteristics, including microvessel density (MVD) (anti-CD-34), vascular permeability (anti-VEGF antigen) and histological grade, were evaluated. Histology revealed 27 pure DCIS and 12 DCIS with invasive foci. In pure DCIS, positive correlations between MVD and amplitude A (r=0.56, P<0.0025) and between MVD and k(21) (r=0.43, P=0.02) were found. As for histological grade, the differences in both functional parameters of grade 1 versus grade 2 and grade 1 versus grades 2 and 3 combined were significant (P<0.05). No significance was found in the analysis of DCIS with invasive foci. Our results indicated that functional MRI-based parameters might possess the potential to predict the outcome of patients with DCIS. Further study will be needed with larger series over longer periods.
Oshida
Keiko
K
General Surgery, Chiba University Graduate School of Medicine, Chiba, Japan. hyaku@mri.biglobe.ne.jp
Nagashima
Takeshi
T
Ueda
Takuya
T
Yagata
Hiroshi
H
Tanabe
Naoto
N
Nakano
Shigeharu
S
Nikaidou
Takashi
T
Funatsu
Hiroyuki
H
Hashimoto
Hideyuki
H
Miyazaki
Masaru
M
D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000098:blood supply / Q000473:pathology*; D002199:Capillary Permeability / Q000502:physiology; D002278:Carcinoma in Situ / Q000098:blood supply / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000098:blood supply / Q000473:pathology*; D003287:Contrast Media / Q000493:pharmacokinetics; D005260:Female; D005544:Forecasting; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008833:Microcirculation / Q000473:pathology; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis
D018952:Antigens, CD34; D003287:Contrast Media; D042461:Vascular Endothelial Growth Factor A; D019786:Gadolinium DTPA