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. [Copyright &y& Elsevier]