Correlation between voxel-wise enhancement parameters on DCE-MRI and pathological prognostic factors in invasive breast cancers

Purpose: To investigate the correlation between enhancement parameters on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and pathologic prognostic factors in invasive breast cancers (BCs). Materials and methods: A total of 25 invasive BCs were included: 22 invasive ductal, 2 invasive lobular and 1 invasive mucinous. The tumor volume was segmented using a semi-automatic software (Olea Sphere). The following voxel-wise enhancement parameters were extracted: (1) time to peak enhancement; (2) signal intensity at peak (SIP); (3) peak enhancement percentage (PEP); (4) post-initial enhancement percentage (PIEP). The following pathological prognostic factors were considered for potential correlation: tumor (pT) and nodal (pN) stage, grading, perivascular/perineural invasion, estrogen/progesterone receptor status, Ki-67 proliferation, and HER2 expression. Spearman and Pearson correlation coefficients were calculated according with type of variable and data distribution. Results: Tumor volume was 2.8\ua0\ub1\ua02.0\ua0cm3(mean\ua0\ub1\ua0standard deviation [SD]). Mean SIP correlated with pT (\u3c1\ua0=\ua00.424, p\ua0=\ua00.035); mean PEP correlated with HER2 overexpression (\u3d5\ua0=\ua00.471, p\ua0=\ua00.017) and pT (\u3c1\ua0=\ua00.449, p\ua0=\ua00.024). The percentage of voxels with fast PEP directly correlated with pT (\u3c1\ua0=\ua00.482, p\ua0=\ua00.015) and pN (\u3c1\ua0=\ua00.446, p\ua0=\ua00.026), while the percentage of voxels with slow PEP inversely correlated with pT (\u3c1\ua0=\ua0 120.421, p\ua0=\ua00.039) and pN (\u3c1\ua0=\ua0 120.481, p\ua0=\ua00.015). Segmentation time was 14.6\ua0\ub1\ua01.3\ua0min (mean\ua0\ub1\ua0SD). Conclusion: In invasive BCs, DCE-MRI voxel-wise enhancement parameters correlated with HER2, pT, and pN