Associations between tumor vascularization assessed by in vivo DCE-MRI and the presence of disseminated tumor cells in bone marrow in breast cancer patients at the time of diagnosis

Purpose To explore possible associations between in vivo pharmacokinetic dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters and the presence of disseminated tumor cells (DTCs) in bone marrow in breast cancer patients at the time of diagnosis. Materials and Methods Thirty-seven women with breast cancer (stage T2–4N0–1M0) were included. Patients were classified as DTC+ if one or more DTCs were detected by immunocytochemistry. DCE-MRI was acquired with a radial 3D T1-weighted spoiled gradient echo sequence with k-space weighted image contrast. Ktrans, kep, and ve were calculated using the extended Tofts model and a population-derived arterial input function. The nonparametric Mann–Whitney U-test was used to compare the histogram distributions of the pharmacokinetic parameters for the DTC+ and the DTC− patients. Results DTCs were detected in 7 of the 37 patients (19%). In DTC+ patients, the distribution of tumor Ktrans and kep were significantly (P < 0.01) more shifted towards lower values than in DTC− patients. Conclusion An association between vascular dependent pharmacokinetic DCE-MRI parameters and the presence of DTCs were found. Compared to DTC− patients, DTC+ patients had poorer perfusion and permeability, indicative of hypoxia. Thus, pharmacokinetic parameters might be surrogate biomarkers of metastatic potential and future relapse.J. Magn. Reson. Imaging 2014;40:1382–1391. © 2014 Wiley Periodicals, Inc.