Dynamic Contrast-Enhanced Magnetic Resonance Imaging and Invasive Breast Cancer: Primary Lesion Kinetics Correlated With Axillary Lymph Node Extracapsular Extension

作者：Loiselle Christopher R^*; Eby Peter R; Peacock Sue; Kim Janice N; Lehman Constance D

来源：Journal of Magnetic Resonance Imaging, 2011, 33(1): 96-101.

DOI：10.1002/jmri.22389

• MRI
• breast cancer
• radiation therapy
• patient selection
• axillary nodes
• extracapsular extension

Purpose: To determine if dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) peak enhancement (PE) of primary breast cancer can predict the presence of lymph node extracapsular extension (LNECE) in patients with axillary metastatic disease.
Materials and Methods: In all, 167 patients treated with radiotherapy for invasive breast cancer from January 1, 2006 to November 1, 2007 were retrospectively identified. Patients with DCE-MRI and surgical axillary staging were included in this study. PE of primary tumors was compared according to axillary nodal status: negative, positive without LNECE, or positive with LNECE. A receiver operator characteristic curve (ROC) was plotted to determine accuracy of PE to predict LNECE.
Results: Forty-six patients met the study criteria. Thirty-two (70%) were node-negative, 9 (19%) were node-positive without LNECE, and 5 (11%) were node-positive with LNECE. PE was greater for patients with LNECE (mean 365%) compared to node-positive patients without LNECE (mean 183%) P = 0.05 and node-negative patients (mean 144%) P = 0.0012. Area under the ROC curve was 0.93.
Conclusion: DCE-MRI PE may be a surrogate marker for LNECE. If validated, DCE-MRI may provide noninvasive kinetic information informing axillary nodal status for patients who receive chemotherapy prior to surgical axillary staging or forego axillary dissection after a positive sentinel node biopsy.

• 出版日期2011-1