Skip to main content
Erschienen in: European Radiology 7/2022

08.04.2022 | Breast

The diffusion MRI signature index is highly correlated with immunohistochemical status and molecular subtype of invasive breast carcinoma

verfasst von: Mariko Goto, Denis Le Bihan, Koji Sakai, Kei Yamada

Erschienen in: European Radiology | Ausgabe 7/2022

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To evaluate the relationship of the signature index (S-index), an advanced diffusion MRI marker, and the immunohistochemical (IHC) status, proliferation rate, and molecular subtype of invasive breast cancers.

Methods

A retrospective study of patients with invasive carcinoma was conducted between 2017 and 2021. All patients underwent dynamic contrast-enhanced MRI and DWI using a 3-T system. For DWI, three b values (0, 200, and 1500 s/mm2) were used to derive the S-index. Three-dimensional ROIs were manually placed over the whole tumor on DWI. Mean and 85th percentile S-index values were compared to the IHC status, proliferation rate, and molecular subtypes of lesions.

Results

The study included 153 patients (mean age, 60 ± 13 years) with 160 invasive carcinomas. S-index values were significantly higher in estrogen receptor–positive (mean, p = .005; 85th percentile, p < .001) and progesterone receptor–positive (mean, p = .003; 85th percentile, p < .001) tumors, and significantly lower in human epidermal growth factor receptor 2 (HER2) – positive tumors (mean, p = .023; 85th percentile, p < .001). Mean and 85th percentile S-index values were significantly different among breast cancer subtypes (mean, p = .015; 85th percentile, p = .002), and the AUC of these values for the prediction of IHC status were 0.64 and 0.66 for HER2, and 0.70 and 0.74 for hormone receptors, respectively.

Conclusions

The DWI S-index showed significantly higher values in invasive carcinomas with immunohistochemical status associated with good prognosis, suggesting its usefulness as a noninvasive imaging biomarker to estimate IHC status and orient treatment.

Key Points

The signature index, an advanced diffusion MRI marker, showed good discrimination of immunohistochemical status in invasive breast carcinomas.
• The signature index has the potential to differentiate noninvasively invasive breast carcinoma subtypes and appears as an imaging biomarker of prognostic factors and molecular phenotypes
Literatur
1.
Zurück zum Zitat Baltzer P, Mann RM, Iima M et al (2020) Diffusion-weighted imaging of the breast-a consensus and mission statement from the EUSOBI International Breast Diffusion-Weighted Imaging working group. Eur Radiol 30:1436–1450CrossRef Baltzer P, Mann RM, Iima M et al (2020) Diffusion-weighted imaging of the breast-a consensus and mission statement from the EUSOBI International Breast Diffusion-Weighted Imaging working group. Eur Radiol 30:1436–1450CrossRef
2.
Zurück zum Zitat Iima M, Honda M, Sigmund EE, Ohno Kishimoto A, Kataoka M, Togashi K (2020) Diffusion MRI of the breast: current status and future directions. J Magn Reson Imaging 52:70–90CrossRef Iima M, Honda M, Sigmund EE, Ohno Kishimoto A, Kataoka M, Togashi K (2020) Diffusion MRI of the breast: current status and future directions. J Magn Reson Imaging 52:70–90CrossRef
3.
Zurück zum Zitat Goldhirsch A, Wood WC, Coates AS et al (2011) Strategies for subtypes--dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol 22:1736–1747CrossRef Goldhirsch A, Wood WC, Coates AS et al (2011) Strategies for subtypes--dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol 22:1736–1747CrossRef
4.
Zurück zum Zitat Mann GB, Fahey VD, Feleppa F, Buchanan MR (2005) Reliance on hormone receptor assays of surgical specimens may compromise outcome in patients with breast cancer. J Clin Oncol 23:5148–5154CrossRef Mann GB, Fahey VD, Feleppa F, Buchanan MR (2005) Reliance on hormone receptor assays of surgical specimens may compromise outcome in patients with breast cancer. J Clin Oncol 23:5148–5154CrossRef
5.
Zurück zum Zitat Burge CN, Chang HR, Apple SK (2006) Do the histologic features and results of breast cancer biomarker studies differ between core biopsy and surgical excision specimens? Breast 15:167–172CrossRef Burge CN, Chang HR, Apple SK (2006) Do the histologic features and results of breast cancer biomarker studies differ between core biopsy and surgical excision specimens? Breast 15:167–172CrossRef
6.
Zurück zum Zitat Orlando L, Viale G, Bria E et al (2016) Discordance in pathology report after central pathology review: implications for breast cancer adjuvant treatment. Breast 30:151–155CrossRef Orlando L, Viale G, Bria E et al (2016) Discordance in pathology report after central pathology review: implications for breast cancer adjuvant treatment. Breast 30:151–155CrossRef
7.
Zurück zum Zitat Martincich L, Deantoni V, Bertotto I et al (2012) Correlations between diffusion-weighted imaging and breast cancer biomarkers. Eur Radiol 22:1519–1528CrossRef Martincich L, Deantoni V, Bertotto I et al (2012) Correlations between diffusion-weighted imaging and breast cancer biomarkers. Eur Radiol 22:1519–1528CrossRef
8.
Zurück zum Zitat Choi SY, Chang YW, Park HJ, Kim HJ, Hong SS, Seo DY (2012) Correlation of the apparent diffusion coefficiency values on diffusion-weighted imaging with prognostic factors for breast cancer. Br J Radiol 85:e474–e479CrossRef Choi SY, Chang YW, Park HJ, Kim HJ, Hong SS, Seo DY (2012) Correlation of the apparent diffusion coefficiency values on diffusion-weighted imaging with prognostic factors for breast cancer. Br J Radiol 85:e474–e479CrossRef
9.
Zurück zum Zitat Horvat JV, Bernard-Davila B, Helbich TH et al (2019) Diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping as a quantitative imaging biomarker for prediction of immunohistochemical receptor status, proliferation rate, and molecular subtypes of breast cancer. J Magn Reson Imaging 50:836–846CrossRef Horvat JV, Bernard-Davila B, Helbich TH et al (2019) Diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping as a quantitative imaging biomarker for prediction of immunohistochemical receptor status, proliferation rate, and molecular subtypes of breast cancer. J Magn Reson Imaging 50:836–846CrossRef
10.
Zurück zum Zitat Iima M, Kataoka M, Kanao S et al (2018) Intravoxel incoherent motion and quantitative non-Gaussian diffusion MR imaging: evaluation of the diagnostic and prognostic value of several markers of malignant and benign breast lesions. Radiology 287:432–441CrossRef Iima M, Kataoka M, Kanao S et al (2018) Intravoxel incoherent motion and quantitative non-Gaussian diffusion MR imaging: evaluation of the diagnostic and prognostic value of several markers of malignant and benign breast lesions. Radiology 287:432–441CrossRef
11.
Zurück zum Zitat Kim EJ, Kim SH, Park GE et al (2015) Histogram analysis of apparent diffusion coefficient at 3.0 t: correlation with prognostic factors and subtypes of invasive ductal carcinoma. J Magn Reson Imaging 42:1666–1678CrossRef Kim EJ, Kim SH, Park GE et al (2015) Histogram analysis of apparent diffusion coefficient at 3.0 t: correlation with prognostic factors and subtypes of invasive ductal carcinoma. J Magn Reson Imaging 42:1666–1678CrossRef
12.
Zurück zum Zitat Lee HS, Kim SH, Kang BJ, Baek JE, Song BJ (2016) Perfusion parameters in dynamic contrast-enhanced MRI and apparent diffusion coefficient value in diffusion-weighted MRI: association with prognostic factors in breast cancer. Acad Radiol 23:446–456CrossRef Lee HS, Kim SH, Kang BJ, Baek JE, Song BJ (2016) Perfusion parameters in dynamic contrast-enhanced MRI and apparent diffusion coefficient value in diffusion-weighted MRI: association with prognostic factors in breast cancer. Acad Radiol 23:446–456CrossRef
13.
Zurück zum Zitat Makkat S, Luypaert R, Stadnik T et al (2008) Deconvolution-based dynamic contrast-enhanced MR imaging of breast tumors: correlation of tumor blood flow with human epidermal growth factor receptor 2 status and clinicopathologic findings--preliminary results. Radiology 249:471–482CrossRef Makkat S, Luypaert R, Stadnik T et al (2008) Deconvolution-based dynamic contrast-enhanced MR imaging of breast tumors: correlation of tumor blood flow with human epidermal growth factor receptor 2 status and clinicopathologic findings--preliminary results. Radiology 249:471–482CrossRef
14.
Zurück zum Zitat Park SH, Choi HY, Hahn SY (2015) Correlations between apparent diffusion coefficient values of invasive ductal carcinoma and pathologic factors on diffusion-weighted MRI at 3.0 Tesla. J Magn Reson Imaging 41:175–182CrossRef Park SH, Choi HY, Hahn SY (2015) Correlations between apparent diffusion coefficient values of invasive ductal carcinoma and pathologic factors on diffusion-weighted MRI at 3.0 Tesla. J Magn Reson Imaging 41:175–182CrossRef
15.
Zurück zum Zitat Shen L, Zhou G, Tong T et al (2018) ADC at 3.0 T as a noninvasive biomarker for preoperative prediction of Ki67 expression in invasive ductal carcinoma of breast. Clin Imaging 52:16–22CrossRef Shen L, Zhou G, Tong T et al (2018) ADC at 3.0 T as a noninvasive biomarker for preoperative prediction of Ki67 expression in invasive ductal carcinoma of breast. Clin Imaging 52:16–22CrossRef
16.
Zurück zum Zitat Surov A, Clauser P, Chang YW et al (2018) Can diffusion-weighted imaging predict tumor grade and expression of Ki-67 in breast cancer? A multicenter analysis. Breast Cancer Res 20:58CrossRef Surov A, Clauser P, Chang YW et al (2018) Can diffusion-weighted imaging predict tumor grade and expression of Ki-67 in breast cancer? A multicenter analysis. Breast Cancer Res 20:58CrossRef
17.
Zurück zum Zitat Bokacheva L, Kaplan JB, Giri DD et al (2014) Intravoxel incoherent motion diffusion-weighted MRI at 3.0 T differentiates malignant breast lesions from benign lesions and breast parenchyma. J Magn Reson Imaging 40:813–823CrossRef Bokacheva L, Kaplan JB, Giri DD et al (2014) Intravoxel incoherent motion diffusion-weighted MRI at 3.0 T differentiates malignant breast lesions from benign lesions and breast parenchyma. J Magn Reson Imaging 40:813–823CrossRef
18.
Zurück zum Zitat Cho GY, Moy L, Kim SG et al (2016) Evaluation of breast cancer using intravoxel incoherent motion (IVIM) histogram analysis: comparison with malignant status, histological subtype, and molecular prognostic factors. Eur Radiol 26:2547–2558CrossRef Cho GY, Moy L, Kim SG et al (2016) Evaluation of breast cancer using intravoxel incoherent motion (IVIM) histogram analysis: comparison with malignant status, histological subtype, and molecular prognostic factors. Eur Radiol 26:2547–2558CrossRef
19.
Zurück zum Zitat Iima M, Le Bihan D (2016) Clinical intravoxel incoherent motion and diffusion MR imaging: past, present, and future. Radiology 278:13–32CrossRef Iima M, Le Bihan D (2016) Clinical intravoxel incoherent motion and diffusion MR imaging: past, present, and future. Radiology 278:13–32CrossRef
20.
Zurück zum Zitat Iima M, Yano K, Kataoka M et al (2015) Quantitative non-Gaussian diffusion and intravoxel incoherent motion magnetic resonance imaging: differentiation of malignant and benign breast lesions. Invest Radiol 50:205–211CrossRef Iima M, Yano K, Kataoka M et al (2015) Quantitative non-Gaussian diffusion and intravoxel incoherent motion magnetic resonance imaging: differentiation of malignant and benign breast lesions. Invest Radiol 50:205–211CrossRef
21.
Zurück zum Zitat Ma D, Lu F, Zou X et al (2017) Intravoxel incoherent motion diffusion-weighted imaging as an adjunct to dynamic contrast-enhanced MRI to improve accuracy of the differential diagnosis of benign and malignant breast lesions. Magn Reson Imaging 36:175–179CrossRef Ma D, Lu F, Zou X et al (2017) Intravoxel incoherent motion diffusion-weighted imaging as an adjunct to dynamic contrast-enhanced MRI to improve accuracy of the differential diagnosis of benign and malignant breast lesions. Magn Reson Imaging 36:175–179CrossRef
22.
Zurück zum Zitat Sun K, Chen X, Chai W et al (2015) Breast cancer: diffusion kurtosis MR imaging-diagnostic accuracy and correlation with clinical-pathologic factors. Radiology 277:46–55CrossRef Sun K, Chen X, Chai W et al (2015) Breast cancer: diffusion kurtosis MR imaging-diagnostic accuracy and correlation with clinical-pathologic factors. Radiology 277:46–55CrossRef
23.
Zurück zum Zitat Goto M, Le Bihan D, Yoshida M, Sakai K, Yamada K (2019) Adding a model-free diffusion MRI marker to BI-RADS assessment improves specificity for diagnosing breast lesions. Radiology 292:84–93CrossRef Goto M, Le Bihan D, Yoshida M, Sakai K, Yamada K (2019) Adding a model-free diffusion MRI marker to BI-RADS assessment improves specificity for diagnosing breast lesions. Radiology 292:84–93CrossRef
24.
Zurück zum Zitat Allison KH, Hammond MEH, Dowsett M et al (2020) Estrogen and progesterone receptor testing in breast cancer: ASCO/CAP guideline update. J Clin Oncol 38:1346–1366CrossRef Allison KH, Hammond MEH, Dowsett M et al (2020) Estrogen and progesterone receptor testing in breast cancer: ASCO/CAP guideline update. J Clin Oncol 38:1346–1366CrossRef
25.
Zurück zum Zitat Wolff AC, Hammond MEH, Allison KH et al (2018) Human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline focused update. J Clin Oncol 36:2105–2122CrossRef Wolff AC, Hammond MEH, Allison KH et al (2018) Human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline focused update. J Clin Oncol 36:2105–2122CrossRef
26.
Zurück zum Zitat Dowsett M, Nielsen TO, A'Hern R et al (2011) Assessment of Ki67 in breast cancer: recommendations from the International Ki67 in Breast Cancer working group. J Natl Cancer Inst 103:1656–1664CrossRef Dowsett M, Nielsen TO, A'Hern R et al (2011) Assessment of Ki67 in breast cancer: recommendations from the International Ki67 in Breast Cancer working group. J Natl Cancer Inst 103:1656–1664CrossRef
27.
Zurück zum Zitat Schnitt SJ (2010) Classification and prognosis of invasive breast cancer: from morphology to molecular taxonomy. Mod Pathol 23(Suppl 2):S60–S64CrossRef Schnitt SJ (2010) Classification and prognosis of invasive breast cancer: from morphology to molecular taxonomy. Mod Pathol 23(Suppl 2):S60–S64CrossRef
28.
Zurück zum Zitat Chen X, Yuan Y, Gu Z, Shen K (2012) Accuracy of estrogen receptor, progesterone receptor, and HER2 status between core needle and open excision biopsy in breast cancer: a meta-analysis. Breast Cancer Res Treat 134:957–967CrossRef Chen X, Yuan Y, Gu Z, Shen K (2012) Accuracy of estrogen receptor, progesterone receptor, and HER2 status between core needle and open excision biopsy in breast cancer: a meta-analysis. Breast Cancer Res Treat 134:957–967CrossRef
29.
Zurück zum Zitat Pinker K, Shitano F, Sala E et al (2018) Background, current role, and potential applications of radiogenomics. J Magn Reson Imaging 47:604–620CrossRef Pinker K, Shitano F, Sala E et al (2018) Background, current role, and potential applications of radiogenomics. J Magn Reson Imaging 47:604–620CrossRef
Metadaten
Titel
The diffusion MRI signature index is highly correlated with immunohistochemical status and molecular subtype of invasive breast carcinoma
verfasst von
Mariko Goto
Denis Le Bihan
Koji Sakai
Kei Yamada
Publikationsdatum
08.04.2022
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 7/2022
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-022-08562-4

Weitere Artikel der Ausgabe 7/2022

European Radiology 7/2022 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.