The predictive value of semi-quantitative parameters of dynamic contrast enhanced magnetic resonance imaging with human epidermal growth factor receptor 2 in breast cancer

doi:10.3877/cma.j.issn.2095-655X.2021.01.010

Abstract

Abstract:

Objective

To investigate the predictive value of semi-quantitative parameters of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) with human epidermal growth factor receptor 2 (Her-2) in breast cancer.

Methods

From January 2016 to December 2019, a total of 65 patients with invasive breast cancer who underwent DCE-MRI in the Imaging Department of Suzhou Hospital Affiliated to Nanjing Medical University and confirmed by pathology were selected. Her-2 expression was detected in all patients by immunohistochemical method, and the patients were divided into Her-2 positive group and Her-2 negative group. Semi-quantitative parameters including rate of contrast enhancement for contrast agent inflow (W-in), rate of contrast decay for contrast agent outflow (W-out), time-to-peak enhancement after contrast agent injection (TTP), positive enhancement integral (PEI) and time-signal intensity curve (TIC) were compared between the two groups. Further, receiver operating characteristic (ROC) curve was used to analyze the effectiveness of each parameter in the diagnosis of positive Her-2.

Results

Among the 65 cases, immunohistochemical staining showed Her-2 positive in 31 cases and Her-2 negative in 34 cases. Compared with Her-2 negative group [1.49±0.21, (0.71±0.12)min], the values of W-in (1.25±0.19) and TTP [(0.55±0.10)min] in the Her-2 positive group were significant decreased (t=-4.99, -5.46, all P<0.01), while the value of W-out (0.28±0.77) in the Her-2 positive group was significant increased compared to Her-2 negative group (0.20±0.08) (t=4.54, P<0.01). However, there was no significant difference in PEI values (145.12±15.81, 141.54±17.69) between the two groups (t=0.85, P>0.05). In addition, TIC types of the two groups were mainly type Ⅱ (11 cases, 15 cases) or Ⅲ (17 cases, 16 cases), and there was no significant difference (χ²=0.42, P>0.05). The area under the curve (AUC) of semi-quantitative parameters combination of DCE-MRI (AUC=0.890) was significant higher than that of single W-in, W-out, TTP, PEI(AUC=0.813, 0.802, 0.829, 0.589) respectively, and the differences of AUC were statistically significant (Z=3.39, 5.24, 3.08, 7.34, all P<0.05).

Conclusion

Semi-quantitative parameters of DCE-MRI have a certain clinical value in the determination of breast cancer with Her-2 positive, and they can provide a reference for clinical treatment.

Key words: Magnetic resonance imaging, Breast cancer, Human epidermal growth factor receptor 2

You Meng, Fan Zhang, Chenlu Liu, Yuying Shen, Qing Cai, Shuangqing Chen. The predictive value of semi-quantitative parameters of dynamic contrast enhanced magnetic resonance imaging with human epidermal growth factor receptor 2 in breast cancer[J]. Chinese Journal of Diagnostics(Electronic Edition), 2021, 09(01): 40-45.

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References 18

[1]	Casey MC, Holian PE, McGuire A，et al.Quantifying Argonaute 2 (Ago2) expression to stratify breast cancer[J]．BMC Cancer，2019(19):712.
[2]	Costantini M, Belli P, Distefano D，et al.Magnetic resonance imaging features in triple-negative breast cancer：comparison with luminal and HER2-overexpressing tumors[J]．Clin Breast Cancer，2012，12(5):331-339.
[3]	曹卫刚，杨振林．乳腺包裹性乳头状癌临床诊断学特征分析[J/CD]．中华诊断学电子杂志，2020，8(2):112-116.
[4]	Cameron D, Piccart-Gebhart MJ, Gelber RD，et al.11 years′ follow-up of trastuzumab after adjuvant chemotherapy in HER-2 positive early breast cancer：final analysis of the HER ceptin adjuvant (HERA) trial[J]．Lancet，2017，389(10075):1195-1205.
[5]	吴晶晶，张妍，林琳，等．ER和PR阴性乳腺癌雄激素受体与HER2表达相关性及其临床意义[J]．中华肿瘤防治杂志，2016，23(23):1544-1549.
[6]	Wang H, Hu Y, Li H，et al.Preliminary study on identification of estrogen receptor-positive breast cancer subtypes based on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) texture analysis[J]．Gland Surgery，2020，9(3):622-628.
[7]	李凡，汪瑞，周军．乳腺癌DCE-MRI表现特征与生物因子表达及淋巴结转移的相关性研究[J]．中国肿瘤外科杂志，2020，12(2):117-125.
[8]	程雪，余日胜，徐民，等．乳腺癌的功能磁共振成像征象与人表皮生长因子受体2表达差异的相关性分析[J]．中华医学杂志，2019，99(31):2440-2444.
[9]	Fan WX, Chen XF, Cheng FY，et al.Retrospective analysis of the utility of multiparametric MRI for differentiating between benign and malignant breast lesions in women in China[J]．Medicine (Baltimore)，2019，97(4):e9666.
[10]	Wildiers H, Tryfonidis K, Lago LD，et al.Pertuzumab and trastuzumab with or without metronomic chemotherapy for older patients with HER2-positive metastatic breast cancer (EORTC 75111-10114)：an open-label，randomised，phase 2 trial from the elderly task force/breast cancer group [J]．Lancet Oncol，2018，19(3):323-336.
[11]	Nagasaka K, Satake H, Ishigaki S，et al.Histogram analysis of quantitative pharmacokinetic parameters on DCE-MRI：correlations with prognostic factors and molecular subtypes in breast cancer[J]．Breast Cancer，2019，26(1):113-124.
[12]	Bhattacharjee A, Rajendra J, Dikshit R，et al.HER2 borderline is a negative prognostic factor for primary malignant breast cancer[J]．Breast Cancer Res Treat，2020，181(1):225-231.
[13]	张骐，张雪宁，吴梦琳，等．不同对比剂剂量对乳腺癌模型DCE-MRI半定量参数影响的研究[J]．国际生物医学工程杂志，2015，389(6):348-352.
[14]	Tao W, Hu C, Bai G, et al. Correlation between the dynamic contrast-enhanced MRI features and prognostic factors in breast cancer：a retrospective case-control study[J]．Medicine (Baltimore)，2018，97(28):e11530.
[15]	Wu M, Lu L, Zhang Q, et al. Relating doses of contrast agent administered to TIC and semi-quantitative parameters on DCE-MRI：based on a murine breast tumor model[J]．PLoS One，2016，11(2):e0149279.
[16]	Xie T, Zhao Q, Fu C，et al.Differentiation of triple-negative breast cancer from other subtypes through whole-tumor histogram analysis on multiparametric MR imaging [J]．Eur Radi，2019，29(5):2535-2544.
[17]	Peng W, Fan J, Xue H. The relationship between DCE-MRI imaging manifestations，semi-quantitative parameters，and VEGF expression in breast cancer[J]．Int J Clin Exp Med，2018，11(7):7224-7231.
[18]	石桥，王霄英，郭丽，等. MRI动态增强流出参数半定量分析对局部进展期乳腺癌新辅助化疗疗效评估的价值 [J]. 中华放射学杂志，2013，47(8):699-703.

项目	AUC	标准误	95% CI	最佳截断值
流入浓度增强率	0.813	0.047	0.705～0.921	1.335
流出浓度衰减率	0.802	0.055	0.695～0.909	0.205
浓度达峰时间(min)	0.829	0.054	0.723～0.935	0.660
正向增强积分	0.589	0.072	0.448～0.730	142.500
参数联合	0.890	0.042	0.808～0.973	2.335

项目	AUC	标准误	95% CI	最佳截断值
流入浓度增强率	0.813	0.047	0.705～0.921	1.335
流出浓度衰减率	0.802	0.055	0.695～0.909	0.205
浓度达峰时间(min)	0.829	0.054	0.723～0.935	0.660
正向增强积分	0.589	0.072	0.448～0.730	142.500
参数联合	0.890	0.042	0.808～0.973	2.335

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