Diffusion-weighted MRI of estrogen receptor-positive, HER2-negative, node-negative breast cancer: association between intratumoral heterogeneity and recurrence risk

Kim, Jin Joo; Hwangbo, Lee; Lee, Ji Won; Lee, Nam Kyung; Nam, Kyung Jin; Choo, Ki Seok; Kang, Taewoo; Park, Heeseung; Son, Yohan; Grimm, Robert

doi:10.1007/s00330-019-06383-6

Cited by 30 publications

(31 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In whole-lesion histogram analysis of the ADC, a volumetric ROI is positioned on the entire lesion over contiguous slices, and a histogram of ADC values reflecting the frequency of voxels is constructed, leading to better evaluation of heterogeneity. Recent studies have suggested that whole-lesion histogram analysis of the ADC might have additional value when assessing the heterogeneity and aggressiveness of breast cancer (17,18). A growing number of studies have used ADC histogram parameters as a potential imaging biomarkers for predicting histopathological features in different tumors, such as Ki-67 (19,20), EGFR (21,22), the hormone receptor status (23,24), and some significant results have been obtained.…”

Section: Introductionmentioning

confidence: 99%

Whole-Lesion Histogram Analysis of the Apparent Diffusion Coefficient as a Quantitative Imaging Biomarker for Assessing the Level of Tumor-Infiltrating Lymphocytes: Value in Molecular Subtypes of Breast Cancer

et al. 2021

View full text Add to dashboard Cite

PurposeTo assess whether apparent diffusion coefficient (ADC) metrics can be used to assess tumor-infiltrating lymphocyte (TIL) levels in breast cancer, particularly in the molecular subtypes of breast cancer.MethodsIn total, 114 patients with breast cancer met the inclusion criteria (mean age: 52 years; range: 29–85 years) and underwent multi-parametric breast magnetic resonance imaging (MRI). The patients were imaged by diffusion-weighted (DW)-MRI (1.5 T) using a single-shot spin-echo echo-planar imaging sequence. Two readers independently drew a region of interest (ROI) on the ADC maps of the whole tumor. The mean ADC and histogram parameters (10th, 25th, 50th, 75th, and 90th percentiles of ADC, skewness, entropy, and kurtosis) were used as features to analyze associations with the TIL levels in breast cancer. Additionally, the correlation between the ADC values and Ki-67 expression were analyzed. Continuous variables were compared with Student’s t-test or Mann-Whitney U test if the variables were not normally distributed. Categorical variables were compared using Pearson’s chi-square test or Fisher’s exact test. Associations between TIL levels and imaging features were evaluated by the Mann-Whitney U and Kruskal-Wallis tests.ResultsA statistically significant difference existed in the 10th and 25th percentile ADC values between the low and high TIL groups in breast cancer (P=0.012 and 0.027). For the luminal subtype of breast cancer, the 10th percentile ADC value was significantly lower in the low TIL group (P=0.041); for the non-luminal subtype of breast cancer, the kurtosis was significantly lower in the low TIL group (P=0.023). The Ki-67 index showed statistical significance for evaluating the TIL levels in breast cancer (P=0.007). Additionally, the skewness was significantly higher for samples with high Ki-67 levels in breast cancer (P=0.029).ConclusionsOur findings suggest that whole-lesion ADC histogram parameters can be used as surrogate biomarkers to evaluate TIL levels in molecular subtypes of breast cancer.

show abstract

Section: Introductionmentioning

confidence: 99%

Whole-Lesion Histogram Analysis of the Apparent Diffusion Coefficient as a Quantitative Imaging Biomarker for Assessing the Level of Tumor-Infiltrating Lymphocytes: Value in Molecular Subtypes of Breast Cancer

et al. 2021

View full text Add to dashboard Cite

show abstract

“…It can provide functional information of tissue microstructure by measuring the random Brownian motion of water molecules and does not require intravenous injection of contrast agent [13]. Kim et al showed that the ADC difference value derived from whole-lesion histogram analysis can be used to assess the recurrence risk in invasive BC patients with positive estrogen receptor (ER), negative HER-2, and negative node disease [14]. Another study demonstrated that maximum whole tumor ADC values may be used to discriminate luminal from other molecular subtypes of BC [15].…”

Section: Introductionmentioning

confidence: 99%

Radiomics Nomogram Based on Radiomics Score from Multiregional Diffusion-Weighted MRI and Clinical Factors for Evaluating HER-2 2+ Status of Breast Cancer

Yin

2021

Diagnostics

View full text Add to dashboard Cite

This study aimed to establish and validate a radiomics nomogram using the radiomics score (rad-score) based on multiregional diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) features combined with clinical factors for evaluating HER-2 2+ status of breast cancer. A total of 223 patients were retrospectively included. Radiomic features were extracted from multiregional DWI and ADC images. Based on the intratumoral, peritumoral, and combined regions, three rad-scores were calculated using the logistic regression model. Independent parameters were selected among clinical factors and combined rad-score (com-rad-score) using multivariate logistic analysis and used to construct a radiomics nomogram. The performance of the nomogram was evaluated using calibration, discrimination, and clinical usefulness. The areas under the receiver operator characteristic curve (AUCs) of intratumoral and peritumoral rad-scores were 0.824/0.763 and 0.794/0.731 in the training and validation cohorts, respectively. Com-rad-score achieved the highest AUC (0.860/0.790) among three rad-scores. ER status and com-rad-score were selected to establish the nomogram, which yielded good discrimination (AUC: 0.883/0.848) and calibration. Decision curve analysis demonstrated the clinical value of the nomogram in the validation cohort. In conclusion, radiomics nomogram, including clinical factors and com-rad-score, showed favorable performance for evaluating HER-2 2+ status in breast cancer.

show abstract

“…distant metastasis-free survival in patients with invasive breast cancer (30) and a high risk of recurrence risk stratified using the Oncotype DX recurrence score in patients with ER-positive, HER2-negative and node-negative breast cancer (31). In our study, ADC difference value of ILC was higher than invasive carcinoma of NST and we presumed that infiltrative growth pattern of ILC made low cellularity area within the tumor and it would cause high ADC area.…”

mentioning

confidence: 50%

“…Recent studies demonstrated the clinical significance of ADC difference value in breast cancer patients (30,31). Higher ADC difference value was related with poorer…”

Section: Discussionmentioning

confidence: 99%

Diffusion-weighted imaging of breast invasive lobular carcinoma: comparison with invasive carcinoma of no special type using a histogram analysis

Jeong¹,

Kim²

2022

Quant Imaging Med Surg

View full text Add to dashboard Cite

Background: To investigate the imaging findings and visibility of breast invasive lobular carcinoma (ILC) on diffusion-weighted imaging (DWI) and compare quantitative apparent diffusion coefficient (ADC) metrics of ILC and invasive carcinoma of no special type (NST) using a histogram analysis. Methods:We performed an observational retrospective study of 629 consecutive women with pathologically proven ILC and invasive ductal carcinoma of NST, who underwent 3-T MRI including DWI,

show abstract

Diffusion-weighted MRI of estrogen receptor-positive, HER2-negative, node-negative breast cancer: association between intratumoral heterogeneity and recurrence risk

Cited by 30 publications

References 27 publications

Whole-Lesion Histogram Analysis of the Apparent Diffusion Coefficient as a Quantitative Imaging Biomarker for Assessing the Level of Tumor-Infiltrating Lymphocytes: Value in Molecular Subtypes of Breast Cancer

Whole-Lesion Histogram Analysis of the Apparent Diffusion Coefficient as a Quantitative Imaging Biomarker for Assessing the Level of Tumor-Infiltrating Lymphocytes: Value in Molecular Subtypes of Breast Cancer

Radiomics Nomogram Based on Radiomics Score from Multiregional Diffusion-Weighted MRI and Clinical Factors for Evaluating HER-2 2+ Status of Breast Cancer

Diffusion-weighted imaging of breast invasive lobular carcinoma: comparison with invasive carcinoma of no special type using a histogram analysis

Contact Info

Product

Resources

About