Associations between tumor vascularization assessed by in vivo DCE-MRI and the presence of disseminated tumor cells in bone marrow in breast cancer patients at the time of diagnosis.
OBJECTIVE
To explore possible associations between in vivo pharmacokinetic dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters and the presence of disseminated tumor cells (DTCs) in bone marrow in breast cancer patients at the time of diagnosis.


METHODS
Thirty-seven women with breast cancer (stage T2-4N0-1M0) were included. Patients were classified as DTC+ if one or more DTCs were detected by immunocytochemistry. DCE-MRI was acquired with a radial 3D T1 -weighted spoiled gradient echo sequence with k-space weighted image contrast. K(trans), kep, and ve were calculated using the extended Tofts model and a population-derived arterial input function. The nonparametric Mann-Whitney U-test was used to compare the histogram distributions of the pharmacokinetic parameters for the DTC+ and the DTC- patients.


RESULTS
DTCs were detected in 7 of the 37 patients (19%). In DTC+ patients, the distribution of tumor K(trans) and kep were significantly (P < 0.01) more shifted towards lower values than in DTC- patients.


CONCLUSIONS
An association between vascular dependent pharmacokinetic DCE-MRI parameters and the presence of DTCs were found. Compared to DTC- patients, DTC+ patients had poorer perfusion and permeability, indicative of hypoxia. Thus, pharmacokinetic parameters might be surrogate biomarkers of metastatic potential and future relapse.
Department of Radiation Biology Institute of Cancer Research, Oslo University Hospital, Norway; Faculty of Medicine, University of Oslo, Norway.
Line B
LB
Nilsen
Anne
A
Fangberget
Oliver M
OM
Geier
Olav
O
Engebraaten
Elin
E
Borgen
Dag Rune
DR
Olsen
Therese
T
Seierstad
D000328:Adult; D000368:Aged; D019046:Bone Marrow Neoplasms / Q000473:pathology* / Q000556:secondary*; D001943:Breast Neoplasms / Q000150:complications / Q000473:pathology*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D009389:Neovascularization, Pathologic / Q000209:etiology / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic
Ktrans; breast cancer; disseminated tumor cells; dynamic contrast-enhanced magnetic resonance imaging; micrometastases; pharmacokinetic modeling