Feasibility analysis of early temporal kinetics as a surrogate marker for breast tumor type, grade, and aggressiveness.
Feasibility analysis of early temporal kinetics as a surrogate marker for breast tumor type, grade, and aggressiveness.
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DOI：
10.1002/jmri.25897
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发表时间：
2018-06
期刊：
影响因子：
--
通讯作者：
Moy L
中科院分区：
文献类型：
--
作者：
Heacock L;Lewin AA;Gao Y;Babb JS;Heller SL;Melsaether AN;Bagadiya N;Kim SG;Moy L
Screening breast MRI has been shown to preferentially detect high grade ductal carcinoma in situ (DCIS) and invasive carcinoma, likely due to increased angiogenesis resulting in early initial uptake of contrast. As interest grows in abbreviated screening breast MRI (AB-MRI), markers of early contrast wash-in that can predict tumor grade and potential aggressiveness are of clinical interest. To evaluate the feasibility of using the initial enhancement ratio (IER) as a surrogate marker for tumor grade, hormone receptor status, and prognostic markers, as an initial step to being incorporated into AB-MRI. Retrospective. 162 women (mean 55.0 years, range 32.8–87.7 years) with 187 malignancies imaged January 2012–November 2015. Images were acquired at 3.0T with a T1-weighted gradient echo fat suppressed volume interpolated breath-hold sequence. Subjects underwent dynamic contrast-enhanced breast MRI with a 7-channel breast coil. IER (% signal increase over baseline at the first post-contrast acquisition) was assessed and correlated with background parenchymal enhancement, washout curves, stage and final pathology. Chi-square test, Spearman rank correlation, Mann-Whitney U tests, Bland-Altman analysis and receiver operating characteristic curve analysis. IER was higher for invasive cancer than for DCIS (R1/R2, p<0.001). IER increased with tumor grade (R1: r=0.56, p<0.001, R2: r=0.50, p<0.001), as ki-67 increased (R1: r=0.35, p<0.001; R2 r=0.35, p<0.001), and for node-positive disease (R1/R2, p=0.001). IER was higher for human epidermal growth factor receptor two-positive and triple negative cancers than for estrogen receptor-positive/progesterone receptor-positive tumors (R1 p<0.001–0.002; R2 p=0.0.001–0.011). IER had higher sensitivity (80.6% vs 75.5%) and specificity (55.8% vs 48.1%) than washout curves for positive nodes, higher specificity (48.1% vs 36.5%) and positive predictive value (70.2% vs 66.7%) for high ki-67, and excellent inter-observer agreement (ICC=0.82). IER, a measurement of early contrast wash-in, is associated with higher-grade malignancies and tumor aggressiveness and might be potentially incorporated into an AB-MRI protocol.
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DOI：
10.2214/ajr.13.11486
发表时间：
2015-03
期刊：
AJR. American journal of roentgenology
影响因子：
--
作者：
Leong LC;Gombos EC;Jagadeesan J;Fook-Chong SM
通讯作者：
Fook-Chong SM
影响因子：
4.4
作者：
Heller, Samantha L.;Moy, Linda;Lavianlivi, Sherlin;Moccaldi, Melanie;Kim, Sungheon
通讯作者：
Kim, Sungheon
影响因子：
3.3
作者：
Mango, Victoria L.;Morris, Elizabeth A.;Jochelson, Maxine S.
通讯作者：
Jochelson, Maxine S.
影响因子：
5
作者：
Brennan, Sandra;Liberman, Laura;Morris, Elizabeth
通讯作者：
Morris, Elizabeth
影响因子：
19.7
作者：
Buadu, LD;Murakami, J;Ohno, S
通讯作者：
Ohno, S