title: Assessment of Invasive Breast Cancer Heterogeneity Using Whole-Tumor Magnetic Resonance Imaging Texture Analysis: Correlations With Detailed Pathological Findings.
abstract: There is no study that investigates the potential correlation between the heterogeneity obtained from texture analysis of medical images and the heterogeneity observed from histopathological findings. We investigated whether texture analysis of magnetic resonance images correlates with histopathological findings.Seventy-five patients with estrogen receptor positive invasive ductal carcinoma who underwent preoperative breast magnetic resonance imaging (MRI) were included. Tumor entropy and uniformity were determined on T2- and contrast-enhanced T1-weighted subtraction images under different filter levels. Two pathologists evaluated the detailed histopathological findings of the tumors including tumor cellularity, dominant stroma type, central scar, histologic grade, extensive intraductal component (EIC), and lymphovascular invasion. Entropy and uniformity values on both T2- and contrast-enhanced T1-weighted subtraction images were compared with detailed pathological findings.In a multivariate analysis, entropy significantly increased only on unfiltered T2-weighted images (P = 0.013). Tumor cellularity and predominant stroma did not affect the uniformity or entropy on both T2- and contrast-enhanced T1-weighted subtraction images. High histologic grades showed increased uniformity and decreased entropy on contrast-enhanced T1-weighted subtraction images, whereas the opposite tendency was observed on T2-weighted images. Invasive ductal carcinoma with an EIC or lymphovascular invasion only affected the contrast-enhanced T1-weighted subtraction images, through increased uniformity and decreased entropy. The best uniformity results were recorded on T2- and contrast-enhanced T1-weighted subtraction images at a filter level of 0.5. Entropy showed the best results at a filter level of 0.5 on contrast-enhanced T1-weighted subtraction images. However, on T2-weighted images, an ideal model was achieved on unfiltered images.MRI texture analysis correlated with pathological tumor heterogeneity.
authors.affiliation: From the Department of Radiology (ESK, J-HK, B-KH); Biostatistics and Clinical Epidemiology Center (YL); Department of Pathology (EYC); and Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Korea (SJN).
authors.forename: Eun Sook
authors.initials: ES
authors.lastname: Ko
authors.forename: Jae-Hun
authors.initials: JH
authors.lastname: Kim
authors.forename: Yaeji
authors.initials: Y
authors.lastname: Lim
authors.forename: Boo-Kyung
authors.initials: BK
authors.lastname: Han
authors.forename: Eun Yoon
authors.initials: EY
authors.lastname: Cho
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Nam
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged
chemical_list: D003287:Contrast Media
references.citation: Radiology. 2011 Oct;261(1):165-71
references.pmid: 21813743
references.citation: Actas Urol Esp. 2013 Jul-Aug;37(7):419-24
references.pmid: 23773823
references.citation: Mod Pathol. 2001 Apr;14(4):325-37
references.pmid: 11301349
references.citation: Magn Reson Med. 2007 Sep;58(3):562-71
references.pmid: 17763361
references.citation: Acad Radiol. 2010 Feb;17(2):135-41
references.pmid: 19945302
references.citation: J Magn Reson Imaging. 2001 Jun;13(6):876-81
references.pmid: 11382947
references.citation: J Clin Oncol. 2007 Oct 1;25(28):4414-22
references.pmid: 17785706
references.citation: Radiology. 2011 Oct;261(1):182-92
references.pmid: 21828186
references.citation: Radiology. 2014 Apr;271(1):30-7
references.pmid: 24475830
references.citation: Cell Oncol. 2007;29(5):387-98
references.pmid: 17726261
references.citation: J Magn Reson Imaging. 2007 Mar;25(3):495-501
references.pmid: 17279534
references.citation: PLoS One. 2014 Aug 07;9(8):e104066
references.pmid: 25102064
references.citation: Cancer Imaging. 2010 Jul 06;10:137-43
references.pmid: 20605762
references.citation: Radiology. 2014 Apr;271(1):143-52
references.pmid: 24475824
references.citation: Clin Radiol. 2004 Dec;59(12):1061-9
references.pmid: 15556588
references.citation: Genes Dev. 2004 Sep 1;18(17):2095-107
references.pmid: 15314031
references.citation: Radiology. 2014 Jul;272(1):100-12
references.pmid: 24654970
references.citation: Radiology. 2009 Feb;250(2):444-52
references.pmid: 19164695
references.citation: Magn Reson Med. 2003 Jul;50(1):92-8
references.pmid: 12815683