Pharmacokinetic analysis of ductal carcinoma in situ of the breast using dynamic MR mammography

The purpose of this study was to assess the relationship between functional parameters derived from dynamic MR imaging and the histological findings of breast ductal carcinoma in situ (DCIS) and DCIS with invasive foci, and to evaluate whether these parameters might predict DCIS patient outcome. Two parameters, amplitude A and k₂₁, were determined from multicompartmental pharmacokinetic analyses of dynamic MR mammography in 39 patients with needle biopsy-proven primary DCIS. After surgery, the histological tumor characteristics, including microvessel density (MVD) (anti-CD-34), vascular permeability (anti-VEGF antigen) and histological grade, were evaluated. Histology revealed 27 pure DCIS and 12 DCIS with invasive foci. In pure DCIS, positive correlations between MVD and amplitude A (r=0.56, P<0.0025) and between MVD and k₂₁ (r=0.43, P=0.02) were found. As for histological grade, the differences in both functional parameters of grade 1 versus grade 2 and grade 1 versus grades 2 and 3 combined were significant (P<0.05). No significance was found in the analysis of DCIS with invasive foci. Our results indicated that functional MRI-based parameters might possess the potential to predict the outcome of patients with DCIS. Further study will be needed with larger series over longer periods.