Ability of dynamic contrast-enhanced magnetic resonance imaging to determine axillary sentinel lymph node status in patients with breast cancer

Abstract

Purpose Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has been confirmed to be a useful technique for identification of lymph node metastasis in patients with breast cancer. However, the value of DCE-MRI for the determination of sentinel lymph node (SLN) status [pN0, pN0(i+), pN1mi, or pN1] is unknown. The aim of this study was to investigate the ability of DCE-MRI to determine SLN status in patients with breast cancer. Methods Fifty-four women with breast cancer (mean age 50.30 ± 11.41 years) who underwent SLN biopsy, DCE-MRI, and axillary lymph node dissection between 2019 and 2021 were enrolled in the study. DCE-MRI kinetic parameters were investigated according to SLN status. Univariable and ordered logistic regression was used to identify risk factors according to SLN status. The diagnostic performance of the kinetic parameters was quantified by the area under the receiver-operating characteristic curve (AUC). Results The findings for DCE-MRI kinetic parameters according to SLN status were statistically significant. Ktrans was the strongest predictor of SLN status. The AUC of Ktrans for distinguishing between metastatic and nonmetastatic SLNs was 0.942 (95% confidence interval [CI] 0.887–0.997, P < 0.001), 0.937 (95% CI 0.874–1.000, P < 0.001) for distinguishing between pN0 to pN1mi and pN1, and 0.928 (95% CI 0.855–1.000, P < 0.001) for distinguishing between pN0 to pN0(i+) and pN1mi to pN1. Conclusion DCE-MRI is a useful diagnostic modality for detection of SLN metastasis. Ktrans is the best single parameter for determination of SLN status.