Magnetic Resonance Imaging Features in Triple-Negative Breast Cancer: Comparison With Luminal and HER2-Overexpressing Tumors

Costantini, Melania; Belli, Paolo; Distefano, Daniela; Bufi, Enida; Matteo, Marialuisa Di; Rinaldi, Pierluigi; Giuliani, Michela; Petrone, Gianluigi; Magno, Stefano; Bonomo, Lorenzo

doi:10.1016/j.clbc.2012.07.002

Cited by 74 publications

(58 citation statements)

References 34 publications

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“…TNBC displayed poorer histologic grade and higher Ki-67 expression (p<0.001) compared to ER-positive subtype BC. This finding was consistent with a previous study by Krizmanich-Conniff et al [13], which found that a higher pathologic grade of TNBC, and two other studies [14,19] showing higher Ki-67 expression as an independent predictor of TNBC.…”

Section: Discussionsupporting

confidence: 93%

Rim sign and histogram analysis of apparent diffusion coefficient values on diffusion-weighted MRI in triple-negative breast cancer: Comparison with ER-positive subtype

et al. 2017

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PurposeTo investigate associations between the clinicopathologic features and MRI features of triple-negative breast cancer (TNBC) and ER-positive breast cancer (BC) via apparent diffusion coefficient (ADC) histogram analysis.Materials and methodsIn this study, 221 breast cancer patients with pre-operative MRI performed from August 2009 to March 2015 were included in a retrospective analysis. All patients had a pathologically confirmed diagnosis of invasive carcinoma and were grouped into ER-positive (149) or triple-negative (72) subtypes. DWI rim sign and various ADC parameters (mean; mode; 25, 50, and 75 percentiles; skewness; and kurtosis) between ER-positive and TNBC were compared using whole-lesion ADC histogram analysis. Univariate and multivariate regression analyses were used for statistical comparison.ResultsDWI rim signs were detected in 42.3% and 41.7% of ER-positive subtype and TNBC, respectively (P = 0.931). TNBC had poorer histologic grade (P<0.001) and higher Ki-67 expression (P <0.001) than ER-positive subtype BC. TNBC displayed higher ADC parameters (mean, mode, 50th & 75th percentiles, kurtosis on univariate analysis, all P<0.001; only kurtosis on multivariate anaylsis; P<0.001) than ER-positive subtype BC. TNBC had significantly more recurrence events than ER-positive subtype BC on univarate analysis (9.7% (7/72) vs. 2.7% (4/149), P = 0.035).ConclusionPoorer clinicopathologic outcomes were found in TNBC. Whole-lesion ADC histogram analysis revealed ADC kurtosis to be higher in TNBC than ER-positive subtype BC.

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Section: Discussionsupporting

confidence: 93%

Rim sign and histogram analysis of apparent diffusion coefficient values on diffusion-weighted MRI in triple-negative breast cancer: Comparison with ER-positive subtype

et al. 2017

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“…Compared to studies [15, 29] that reported a higher ADC value in TN cancers, we observed a low ADC value (in our series, TN cancers are predominately mass lesions). Our results are similar to the ER positive tumors reported by Costantini et al [28] which had lower ADC values in TN lesions than those observed in the HER2-overexpressing subgroup, although with no statistical significance.…”

Section: Discussionsupporting

confidence: 89%

“…The difference in the ADC values between IDC and ILC could result from different growth patterns and, lower cellularity of ILC [27]. The molecular subtype categories (TN, ER and HER2) have different behaviors and aggressiveness [28] but without significantly different ADC values. Compared to studies [15, 29] that reported a higher ADC value in TN cancers, we observed a low ADC value (in our series, TN cancers are predominately mass lesions).…”

Section: Discussionmentioning

confidence: 99%

Quantitative apparent diffusion coefficient measurement obtained by 3.0Tesla MRI as a potential noninvasive marker of tumor aggressiveness in breast cancer

Durando

Gennaro

Cho

et al. 2016

European Journal of Radiology

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Purpose To assess the association between apparent diffusion coefficient (ADC), and histological prognostic parameters in malignant breast lesions. The ability of ADC to identify lesions with the presence of Lymphovascular invasion (LVI) in breast carcinoma was also examined. Materials and Methods This HIPAA-compliant retrospective study consisted of 212 consecutive patients with known cancers who underwent 3.0T MRI between January 2011 and 2013. In this study, a total of 126 malignant lesions in 114 women, who had undergone DWI (b-values of 0 and 1000 s/mm2) in addition to diagnostic MRI, were included. Patients with less than 0.8 cm lesions, or those who underwent neoadjuvant chemotherapy or suboptimal DW images were excluded. Classical prognostic factors [lesion size, histopathological type and grade, lymph node (LN) status and lymphovascular invasion (LVI)], molecular prognostic markers [estrogen receptor (ER), progesterone receptor (PR) and human epidermal grow factor receptor 2(HER2)] were reviewed and recorded. A region of interest (ROI) was drawn within the lesions to measure ADC values. Statistical analyses were performed by the Wilcoxon rank sum test (statistical significance at P<0.05). Adjusted p values from multiple comparison analysis were also calculated. Results This study demonstrates an inverse correlation between ADC and LVI in malignant lesions and the ability of ADC to identify aggressiveness in lesions with positive LVI. Tumor size, grade, ER, PR, HER2 and lymph node status did not impact tumor ADC value. However, tumors with LVI showed significantly lower ADC values when compared to tumors without LVI, regardless of the enhancement type, histological grade, histological type, and LN status. Conclusion Our study shows that ADC could be a potential clinical adjunct in the evaluation of prognostic factors related to malignant lesion aggressiveness such as LVI.

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“…Signals from DW-MRI originate from restrictions to the random movement of water between cell membranes of tissues, which reflects tumor cellularity and the integrity of cell membranes (3). The quick imaging without the need for an exogenous contrast medium allows the clinical application of DW-MRI with ADC to expand from the differentiation of benign and malignant tumors, the screening of cancers and the monitoring of the response to chemotherapeutic treatment to prognostic applications (4, 5, 6, 7, 8, 9). Recently, a study using the xenograft tumor model found that ADC values of the solid portion of tumors correlated with intratumoral necrosis and microvessel density in prostate cancers (10).…”

Section: Introductionmentioning

confidence: 99%

Intratumoral Heterogeneity of Breast Cancer Xenograft Models: Texture Analysis of Diffusion-Weighted MR Imaging

Yun

Cho

et al. 2014

Korean J Radiol

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ObjectiveTo investigate whether there is a relationship between texture analysis parameters of apparent diffusion coefficient (ADC) maps and histopathologic features of MCF-7 and MDA-MB-231 xenograft models.Materials and MethodsMCF-7 estradiol (+), MCF-7 estradiol (-), and MDA-MB-231 xenograft models were made with approval of the animal care committee. Twelve tumors of MCF-7 estradiol (+), 9 tumors of MCF-7 estradiol (-), and 6 tumors in MDA-MB-231 were included. Diffusion-weighted MR images were obtained on a 9.4-T system. An analysis of the first and second order texture analysis of ADC maps was performed. The texture analysis parameters and histopathologic features were compared among these groups by the analysis of variance test. Correlations between texture parameters and histopathologic features were analyzed. We also evaluated the intraobserver agreement in assessing the texture parameters.ResultsMCF-7 estradiol (+) showed a higher standard deviation, maximum, skewness, and kurtosis of ADC values than MCF-7 estradiol (-) and MDA-MB-231 (p < 0.01 for all). The contrast of the MCF-7 groups was higher than that of the MDA-MB-231 (p = 0.004). The correlation (COR) of the texture analysis of MCF-7 groups was lower than that of MDA-MB-231 (p < 0.001). The histopathologic analysis showed that Ki-67mean and Ki-67diff of MCF-7 estradiol (+) were higher than that of MCF-7 estradiol (-) or MDA-MB-231 (p < 0.05). The microvessel density (MVD)mean and MVDdiff of MDA-MB-231 were higher than those of MCF-7 groups (p < 0.001). A diffuse-multifocal necrosis was more frequently found in MDA-MB-231 (p < 0.001). The proportion of necrosis moderately correlated with the contrast (r = -0.438, p = 0.022) and strongly with COR (r = 0.540, p = 0.004). Standard deviation (r = 0.622, r = 0.437), skewness (r = 0.404, r = 0.484), and kurtosis (r = 0.408, r = 0.452) correlated with Ki-67mean and Ki-67diff (p < 0.05 for all). COR moderately correlated with Ki-67diff (r = -0.388, p = 0.045). Skewness (r = -0.643, r = -0.464), kurtosis (r = -0.581, r = -0.389), contrast (r = -0.473, r = -0.549) and COR (r = 0.588, r = 0.580) correlated with MVDmean and MVDdiff (p < 0.05 for all).ConclusionThe texture analysis of ADC maps may help to determine the intratumoral spatial heterogeneity of necrosis patterns, amount of cellular proliferation and the vascularity in MCF-7 and MDA-MB-231 xenograft breast cancer models.

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Magnetic Resonance Imaging Features in Triple-Negative Breast Cancer: Comparison With Luminal and HER2-Overexpressing Tumors

Cited by 74 publications

References 34 publications

Rim sign and histogram analysis of apparent diffusion coefficient values on diffusion-weighted MRI in triple-negative breast cancer: Comparison with ER-positive subtype

Rim sign and histogram analysis of apparent diffusion coefficient values on diffusion-weighted MRI in triple-negative breast cancer: Comparison with ER-positive subtype

Quantitative apparent diffusion coefficient measurement obtained by 3.0Tesla MRI as a potential noninvasive marker of tumor aggressiveness in breast cancer

Intratumoral Heterogeneity of Breast Cancer Xenograft Models: Texture Analysis of Diffusion-Weighted MR Imaging

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