Dynamic Contrast-Enhanced and Diffusion-Weighted MRI of Estrogen Receptor-Positive Invasive Breast Cancers: Associations Between Quantitative MR Parameters and Ki-67 Proliferation Status

作者：Shin Jong Ki; Kim Jin You^*

来源：Journal of Magnetic Resonance Imaging, 2017, 45(1): 94-102.

DOI：10.1002/jmri.25348

Purpose: To explore the association between quantitative parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) and Ki-67 proliferation status in patients with estrogen receptor (ER)-positive invasive breast cancer.
Materials and Methods: We retrospectively reviewed the records of 88 patients with ER-positive invasive breast cancer who underwent preoperative DCE-MRI and DWI on a 3T scanner. Perfusion parameters (K-trans, K-ep, and V-e) and apparent diffusion coefficients (ADCs) were recorded, and we correlated these data with the Ki-67 status. The Ki-67 proliferation index was categorized as high (>= 14%) or low (< 14%).
Results: In the high-Ki-67 group, the mean K-trans was significantly higher (P<0.001) than that of the low-Ki-67 group, and the mean ADC significantly lower (P<0.001). However, the mean K-ep and V-e values did not differ between the two groups (P=0.248 and P=0.055, respectively). Univariate analysis showed that a higher K-trans (>0.274), a lower ADC (<= 0.893310 23 mm(2)/s), a larger tumor size (> 2 cm), a higher histological grade (grade 3), the presence of axillary metastasis, and positive P53 status were significantly associated with high-Ki-67 status (all P values<0.05). Of these variables, a higher K-trans (>0.274; adjusted odds ratio [OR] 59.027, 95% confidence interval [CI] 51.929-42.245; P50.005) and a higher histological grade (grade 3; adjusted OR57.510, 95% CI51.305-43.205; P=0.024) independently predicted a high Ki-67 status.
Conclusion: K-trans derived from DCE-MRI is associated independently with the Ki-67 proliferation status in patients with ER-positive invasive breast cancer.

• 出版日期2017-1