Predicting of Ki-67 Expression Level Using Diffusion-Weighted and Synthetic Magnetic Resonance Imaging in Invasive Ductal Breast Cancer

Abstract

Objectives. To investigate the association between quantitative parameters generated using synthetic magnetic resonance imaging (SyMRI) and diffusion-weighted imaging (DWI) and Ki-67 expression level in patients with invasive ductal breast cancer (IDC). Method. We retrospectively reviewed the records of patients with IDC who underwent SyMRI and DWI before treatment. Precontrast and postcontrast relaxation times (T1, longitudinal; T2, transverse), proton density (PD) parameters, and apparent diffusion coefficient (ADC) values were measured in breast lesions. Univariate and multivariate regression analyses were performed to screen for statistically significant variables to differentiate the high (≥30%) and low (<30%) Ki-67 expression groups. Their performance was evaluated by receiver operating characteristic (ROC) curve analysis. Results. We analyzed 97 patients. Multivariate regression analysis revealed that the high Ki-67 expression group (n = 57) had significantly higher parameters generated using SyMRI (pre-T1, p = 0.001 ) and lower ADC values ( p = 0.036 ) compared with the low Ki-67 expression group (n = 40). Pre-T1 showed the best diagnostic performance for predicting the Ki-67 expression level in patients with invasive ductal breast cancer (areas under the ROC curve (AUC), 0.711; 95% confidence interval (CI), 0.609–0.813). Conclusions. Pre-T1 could be used to predict the pretreatment Ki-67 expression level in invasive ductal breast cancer.

Artificial intelligence-powered optimization of KI-67 assessment in breast cancer: enhancing precision and workflow efficiency. a literature review

“…3,14,15,20 The behaviour of the Ki-67 indexes following neoadjuvant chemotherapy varies, as it can decrease, increase, or remain unchanged. 4,10,21,22 As elevated pre-treatment Ki-67 values are associated with an increased likelihood of achieving a pathologic complete response, a high Ki-67 proliferation rate post-neoadjuvant treatment is indicative of an unfavourable prognosis. 23 Notably, the predictive value of Ki-67 varies between Her2-positive and hormone receptor-positive BCs, with lower predictive values observed for Her2-positive tumours.…”