Morphological and kinetic characteristics of dynamic contrast-enhanced MRI (DCE-MRI) correlated with histopathological factors of breast cancer: A potential prognostic role of breast MRI?

Abstract

Purpose

To explore the correlation of morphological and kinetic DCE-MRI features with histopathological prognostic factors of invasive breast cancer.

Material and methods

Fifty-one women with 57 cancerous lesions underwent DCE-MRI prior to surgery. DCE-MRI findings were interpreted with a multifactorial classification system that included morphological (shape, margins and pattern of enhancement) and kinetic characteristics (initial signal increase and post-initial behaviour of the time-signal intensity curve). Each morphological and kinetic parameter was scored with 0, 1 or 2 points and the total score was estimated. Finally each lesion was classified into one of the five categories that correspond to the five ACR BI-RADS categories. Statistical analysis was performed to correlate DCE-MR imaging parameters and histopathological findings using Fisher's exact test and stepwise multiple regression analysis.

Results

Increase of the signal intensity at the initial phase >100% was strongly correlated with positive lymph nodes (p = 0.008, OR 0.054). Types I and II time-signal intensity curves at the post-initial phase were associated with a fourfold increase in the likelihood of progesterone receptors positivity (p = 0.022, OR 4). Finally, high total score was positively correlated with affected lymph nodes (p = 0.033, OR 0.29).

There was a trend regarding ill-defined margins of the tumor (p = 0.08) and vascular infiltration and also high score and neural infiltration (p = 0.072).

Conclusion

A multivariate interpretation model for DCE-MRI that includes morphological and kinetic characteristics has prognostic value for invasive breast cancer. Early initial contrast agent uptake and a high overall score are associated with poor prognostic factors.