Korean J Radiol.  2019 Mar;20(3):411-421. 10.3348/kjr.2018.0587.

Kinetic Features of Invasive Breast Cancers on Computer-Aided Diagnosis Using 3T MRI Data: Correlation with Clinical and Pathologic Prognostic Factors

• Song SE
• Cho KR
• Seo BK
• Woo OH
• Jung SP
• Sung DJ

• KMID: 2438271
• DOI: http://doi.org/10.3348/kjr.2018.0587

Abstract

OBJECTIVE
To investigate the correlation of kinetic features of breast cancers on computer-aided diagnosis (CAD) of preoperative 3T magnetic resonance imaging (MRI) data and clinical-pathologic factors in breast cancer patients.
MATERIALS AND METHODS
Between July 2016 and March 2017, 85 patients (mean age, 54 years; age range, 35-81 years) with invasive breast cancers (mean, 1.8 cm; range, 0.8-4.8 cm) who had undergone MRI and surgery were retrospectively enrolled. All magnetic resonance images were processed using CAD, and kinetic features of tumors were acquired. The relationships between kinetic features and clinical-pathologic factors were assessed using Spearman correlation test and binary logistic regression analysis.
RESULTS
Peak enhancement and angio-volume were significantly correlated with histologic grade, Ki-67 index, and tumor size: r = 0.355 (p = 0.001), r = 0.330 (p = 0.002), and r = 0.231 (p = 0.033) for peak enhancement, r = 0.410 (p = 0.005), r = 0.341 (p < 0.001), and r = 0.505 (p < 0.001) for angio-volume. Delayed-plateau component was correlated with Ki-67 (r = 0.255 [p = 0.019]). In regression analysis, higher peak enhancement was associated with higher histologic grade (odds ratio [OR] = 1.004; 95% confidence interval [CI]: 1.001-1.008; p = 0.024), and higher delayed-plateau component and angio-volume were associated with higher Ki-67 (OR = 1.051; 95% CI: 1.011-1.094; p = 0.013 for delayed-plateau component, OR = 1.178; 95% CI: 1.023-1.356; p = 0.023 for angio-volume).
CONCLUSION
Of the CAD-assessed kinetic features, higher peak enhancement may correlate with higher histologic grade, and higher delayed-plateau component and angio-volume correlate with higher Ki-67 index. These results support the clinical application of kinetic features in prognosis assessment.

Keyword

Breast Neoplasms; MRI; Prognostic factor; Computer-aided diagnosis (CAD); Kinetic feature

MeSH Terms

Breast Neoplasms
Breast*
Diagnosis*
Humans
Logistic Models
Magnetic Resonance Imaging*
Prognosis
Retrospective Studies

Figure

• 

  Fig. 1 MR image with CAD angio-map of 48-year-old woman with right breast cancer.Auto-portfolio of CAD system indicates tumor enhancement kinetics with 295% peak enhancement, 99% early-rapid component and 45% delayed-plateau component. Patient underwent modified radical mastectomy. Surgical pathologic examination revealed 2.8-cm invasive ductal carcinoma with histologic grade III that was ER negative, PR negative, and HER2 positive. Axillary LN metastasis was not found. Ki-67 index was 20%. CAD = computer-aided diagnosis, ER = estrogen receptor, HER2 = human epidermal growth factor receptor type 2, LN= lymph node, MR = magnetic resonance, PR = progesterone receptor

• 

  Fig. 2 MR image with CAD angio-map of 66-year-old woman with right breast cancer.Auto-portfolio of CAD system indicates tumor enhancement kinetics with 155% peak enhancement, 70% early-rapid component and 1% delayed-plateau component. Patient underwent breast-conserving surgery. Surgical pathologic examination revealed 1.6-cm invasive ductal carcinoma with histologic grade I that was ER positive, PR negative, and HER2 negative. Axillary LN metastasis was not found. Ki-67 index was 5%.

• 

  Fig. 3 Boxplots of CAD-assessed kinetic features according to clinical-pathologic factors.A. Median peak enhancement was significantly higher according to higher histologic grade (p = 0.005). B. Median angio-volume was significantly larger in tumors ≥ 2 cm than in tumors < 2 cm (p < 0.001). C. Median delayed-plateau component was significantly higher in ER-negative tumors than in ER-positive tumors (p = 0.006). D. Median delayed-plateau component was significantly higher in tumors with high Ki-67 index than in tumors with low Ki-67 index (p = 0.030).

• 

  Fig. 4 Scatter plots of angio-volume according to tumor size and Ki-67 index.A. Angio-volume was significantly correlated with tumor size (Spearman's rho = 0.505, p < 0.001). B. Angio-volume was significantly correlated with Ki-67 index (Spearman's rho = 0.341, p < 0.001).

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