Dynamic contrast-enhanced and diffusion-weighted MRI of estrogen receptor-positive invasive breast cancers: Associations between quantitative MR parameters and Ki-67 proliferation status.
To explore the association between quantitative parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) and Ki-67 proliferation status in patients with estrogen receptor (ER)-positive invasive breast cancer.



We retrospectively reviewed the records of 88 patients with ER-positive invasive breast cancer who underwent preoperative DCE-MRI and DWI on a 3T scanner. Perfusion parameters (Ktrans, Kep, and Ve) and apparent diffusion coefficients (ADCs) were recorded, and we correlated these data with the Ki-67 status. The Ki-67 proliferation index was categorized as high (≥14%) or low (<14%).



In the high-Ki-67 group, the mean Ktranswas significantly higher (P < 0.001) than that of the low-Ki-67 group, and the mean ADC significantly lower (P < 0.001). However, the mean Kepand Vevalues did not differ between the two groups (P = 0.248 and P = 0.055, respectively). Univariate analysis showed that a higher Ktrans(>0.274), a lower ADC (≤0.893 × 10-3mm2/s), a larger tumor size (>2 cm), a higher histological grade (grade 3), the presence of axillary metastasis, and positive P53 status were significantly associated with high-Ki-67 status (all P values < 0.05). Of these variables, a higher Ktrans(>0.274; adjusted odds ratio [OR] = 9.027, 95% confidence interval [CI] = 1.929-42.245; P = 0.005) and a higher histological grade (grade 3; adjusted OR = 7.510, 95% CI = 1.305-43.205; P = 0.024) independently predicted a high Ki-67 status.



Ktransderived from DCE-MRI is associated independently with the Ki-67 proliferation status in patients with ER-positive invasive breast cancer.



4 J. Magn. Reson. Imaging 2017;45:94-102.
Medical Research Institute, Pusan National University School of Medicine, Busan, Republic of Korea.
Jong Ki
JK
Shin
Medical Research Institute, Pusan National University School of Medicine, Busan, Republic of Korea.|Department of Radiology, Pusan National University Hospital, Busan, Republic of Korea.
Jin You
JY
Kim
D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011960:Receptors, Estrogen / Q000378:metabolism*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D014408:Biomarkers, Tumor; D003287:Contrast Media; D019394:Ki-67 Antigen; D011960:Receptors, Estrogen
Ki-67; breast neoplasm; diffusion MRI; dynamic contrast-enhanced MRI