Tumor apparent diffusion coefficient as an imaging biomarker to predict tumor aggressiveness in patients with estrogen‐receptor‐positive breast cancer |
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| Authors: | Hee Jung Shin So Hee Kim Hee Jin Lee Gyungyub Gong Seunghee Baek Eun Young Chae Woo Jung Choi Joo Hee Cha Hak Hee Kim |
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| Affiliation: | 1. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan, College of Medicine, Songpa‐gu, Seoul, South Korea;2. Department of Pathology, Asan Medical Center, University of Ulsan, College of Medicine, Songpa‐gu, Seoul, South Korea;3. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan, College of Medicine, Songpa‐gu, Seoul, South Korea |
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| Abstract: | The purpose of this retrospective study was to evaluate whether tumor apparent diffusion coefficient (ADC) was correlated with pathologic biomarkers such as tumor cellularity, Ki67, tumor‐infiltrating lymphocytes (TILs), and peritumoral lymphocytic infiltrate (PLI) in patients with estrogen receptor (ER)‐positive breast cancer. The study was approved by the institutional review board and informed consent was waived. From July 2014 to December 2014, we reviewed 140 ER‐positive tumors in 138 consecutive patients (range, 28–77 years; mean, 52 years) who underwent preoperative breast MRI and definitive surgery. All patients underwent diffusion‐weighted imaging with a 3T scanner. Two radiologists drew the region of interest of the entire tumor and obtained the mean and pixel‐based histogram of ADC. On pathology, two pathologists reviewed tumor cellularity, Ki67, TILs, and PLI. Multiple linear regression analysis was used to determine pathologic variables independently associated with ADC. Tumors with high tumor cellularity and high Ki67 had significantly lower ADCs than those with low tumor cellularity and low Ki67 (P < 0.05 for all). Tumors without PLI had significantly higher standard deviation than those with PLI (0.23 ± 0.08 versus 0.18 ± 0.05; P < 0.001). Median ADC was negatively correlated with tumor cellularity (r = ?0.441), and Ki67 (r = ?0.382). The standard deviation of ADC was also negatively correlated with the degree of PLI (r = ?0.319). On multivariate linear regression analysis, tumor cellularity and Ki67 were independently associated with tumor ADC. Tumor ADC would be an MRI biomarker for the prediction of tumor aggressiveness indicators such as Ki67, tumor cellularity, and PLI in ER‐positive breast cancer. Copyright © 2016 John Wiley & Sons, Ltd. |
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| Keywords: | breast neoplasm Ki67 tumor cellularity diffusion‐weighted imaging |
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