Limits...
Relationship between morphological features and kinetic patterns of enhancement of the dynamic breast magnetic resonance imaging and clinico-pathological and biological factors in invasive breast cancer.

Fernández-Guinea O, Andicoechea A, González LO, González-Reyes S, Merino AM, Hernández LC, López-Muñiz A, García-Pravia P, Vizoso FJ - BMC Cancer (2010)

Bottom Line: However, there was a significant and positive association between the mitotic index and the peak of maximum intensity (p = 0.036).Peritumor inflammation was significantly associated with washout curve type III (p = 0.042).Variations in the early phase of dynamic MRI seem to be associated with parameters indicatives of tumor aggressiveness in breast cancer.

View Article: PubMed Central - HTML - PubMed

Affiliation: Unidad de Investigación, Hospital de Jove, Gijón-Spain.

ABSTRACT

Background: To investigate the relationship between the magnetic resonance imaging (MRI) features of breast cancer and its clinicopathological and biological factors.

Methods: Dynamic MRI parameters of 68 invasive breast carcinomas were investigated. We also analyzed microvessel density (MVD), estrogen and progesterone receptor status, and expression of p53, HER2, ki67, VEGFR-1 and 2.

Results: Homogeneous enhancement was significantly associated with smaller tumor size (T1: < 2 cm) (p = 0.015). Tumors with irregular or spiculated margins had a significantly higher MVD than tumors with smooth margins (p = 0.038). Tumors showing a maximum enhancement peak at two minutes, or longer, after injecting the contrast, had a significantly higher MVD count than those which reached this point sooner (p = 0.012). The percentage of tumors with vascular invasion or high mitotic index was significantly higher among those showing a low percentage (150%) of enhancement rate (p = 0.016 and p = 0.03, respectively). However, there was a significant and positive association between the mitotic index and the peak of maximum intensity (p = 0.036). Peritumor inflammation was significantly associated with washout curve type III (p = 0.042).

Conclusions: Variations in the early phase of dynamic MRI seem to be associated with parameters indicatives of tumor aggressiveness in breast cancer.

Show MeSH

Related in: MedlinePlus

Breast MR image acquired in a 45-years-old patient with a palpable mass in the left upper outer quadrant. The axial postcontrast subtracted image (9.9/4.2; flip angle, 10°) depicts a lesion with irregular margin of mass and heterogeneous enhancement (arrow). The time-signal intensity curve of this shows a type III (washout) curve. (A). Microphotography of the same tumor showing a peritumoral inflammation (arrows). 200×. (B). Breast MR image acquired in a 63-years-old patient with a palpable mass in the left upper outer quadrant. The axial postcontrast subtracted image (9.9/4.2; flip angle, 10°) depicts a lesion of irregular margin of mass (arrow). The time-signal intensity curve of this shows a type I curve. (C). Microphotography of the same tumor showing no a peritumoral inflammation. 100×. (D).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2819997&req=5

Figure 2: Breast MR image acquired in a 45-years-old patient with a palpable mass in the left upper outer quadrant. The axial postcontrast subtracted image (9.9/4.2; flip angle, 10°) depicts a lesion with irregular margin of mass and heterogeneous enhancement (arrow). The time-signal intensity curve of this shows a type III (washout) curve. (A). Microphotography of the same tumor showing a peritumoral inflammation (arrows). 200×. (B). Breast MR image acquired in a 63-years-old patient with a palpable mass in the left upper outer quadrant. The axial postcontrast subtracted image (9.9/4.2; flip angle, 10°) depicts a lesion of irregular margin of mass (arrow). The time-signal intensity curve of this shows a type I curve. (C). Microphotography of the same tumor showing no a peritumoral inflammation. 100×. (D).

Mentions: Table 1 also shows the relationship between morphological features, kinetic pattern of enhancement and clinicopathological patient and tumor characteristics. Among all these factors, we found significant associations of MRI parameters with vascular invasion, mitotic index and peritumor inflammation. The percentage of tumors with vascular invasion or with high mitotic index was significantly superior among those showing a low percentage of maximum enhancement (≤ 150%) before two minutes than in those showing a high percentage (>150%) of enhancement rate at that time interval (p = 0.016 and p = 0.03, respectively). However, in contrast, there was a significant and positive association between the rate of mitotic index and the peak of maximum enhancement before two minuets (p = 0.036). Moreover, the percentage of tumors with peritumor inflammation was considerably higher in those showing type III curves than in those with either types I or II curves (p = 0.042), as well as when we compared both type I and type II with type III (p = 0.035). Figure 2 shows representative examples of this association. On the other hand, our results did not show significant associations between the different MRI parameters and menopausal status, nodal status, histotologial grade (Table 1), patient's age, desmoplastic reaction, tumor advancing edge, perineural invasion, necrosis, histological type, nuclear grade or DCIS associated component (data not shown).


Relationship between morphological features and kinetic patterns of enhancement of the dynamic breast magnetic resonance imaging and clinico-pathological and biological factors in invasive breast cancer.

Fernández-Guinea O, Andicoechea A, González LO, González-Reyes S, Merino AM, Hernández LC, López-Muñiz A, García-Pravia P, Vizoso FJ - BMC Cancer (2010)

Breast MR image acquired in a 45-years-old patient with a palpable mass in the left upper outer quadrant. The axial postcontrast subtracted image (9.9/4.2; flip angle, 10°) depicts a lesion with irregular margin of mass and heterogeneous enhancement (arrow). The time-signal intensity curve of this shows a type III (washout) curve. (A). Microphotography of the same tumor showing a peritumoral inflammation (arrows). 200×. (B). Breast MR image acquired in a 63-years-old patient with a palpable mass in the left upper outer quadrant. The axial postcontrast subtracted image (9.9/4.2; flip angle, 10°) depicts a lesion of irregular margin of mass (arrow). The time-signal intensity curve of this shows a type I curve. (C). Microphotography of the same tumor showing no a peritumoral inflammation. 100×. (D).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2819997&req=5

Figure 2: Breast MR image acquired in a 45-years-old patient with a palpable mass in the left upper outer quadrant. The axial postcontrast subtracted image (9.9/4.2; flip angle, 10°) depicts a lesion with irregular margin of mass and heterogeneous enhancement (arrow). The time-signal intensity curve of this shows a type III (washout) curve. (A). Microphotography of the same tumor showing a peritumoral inflammation (arrows). 200×. (B). Breast MR image acquired in a 63-years-old patient with a palpable mass in the left upper outer quadrant. The axial postcontrast subtracted image (9.9/4.2; flip angle, 10°) depicts a lesion of irregular margin of mass (arrow). The time-signal intensity curve of this shows a type I curve. (C). Microphotography of the same tumor showing no a peritumoral inflammation. 100×. (D).
Mentions: Table 1 also shows the relationship between morphological features, kinetic pattern of enhancement and clinicopathological patient and tumor characteristics. Among all these factors, we found significant associations of MRI parameters with vascular invasion, mitotic index and peritumor inflammation. The percentage of tumors with vascular invasion or with high mitotic index was significantly superior among those showing a low percentage of maximum enhancement (≤ 150%) before two minutes than in those showing a high percentage (>150%) of enhancement rate at that time interval (p = 0.016 and p = 0.03, respectively). However, in contrast, there was a significant and positive association between the rate of mitotic index and the peak of maximum enhancement before two minuets (p = 0.036). Moreover, the percentage of tumors with peritumor inflammation was considerably higher in those showing type III curves than in those with either types I or II curves (p = 0.042), as well as when we compared both type I and type II with type III (p = 0.035). Figure 2 shows representative examples of this association. On the other hand, our results did not show significant associations between the different MRI parameters and menopausal status, nodal status, histotologial grade (Table 1), patient's age, desmoplastic reaction, tumor advancing edge, perineural invasion, necrosis, histological type, nuclear grade or DCIS associated component (data not shown).

Bottom Line: However, there was a significant and positive association between the mitotic index and the peak of maximum intensity (p = 0.036).Peritumor inflammation was significantly associated with washout curve type III (p = 0.042).Variations in the early phase of dynamic MRI seem to be associated with parameters indicatives of tumor aggressiveness in breast cancer.

View Article: PubMed Central - HTML - PubMed

Affiliation: Unidad de Investigación, Hospital de Jove, Gijón-Spain.

ABSTRACT

Background: To investigate the relationship between the magnetic resonance imaging (MRI) features of breast cancer and its clinicopathological and biological factors.

Methods: Dynamic MRI parameters of 68 invasive breast carcinomas were investigated. We also analyzed microvessel density (MVD), estrogen and progesterone receptor status, and expression of p53, HER2, ki67, VEGFR-1 and 2.

Results: Homogeneous enhancement was significantly associated with smaller tumor size (T1: < 2 cm) (p = 0.015). Tumors with irregular or spiculated margins had a significantly higher MVD than tumors with smooth margins (p = 0.038). Tumors showing a maximum enhancement peak at two minutes, or longer, after injecting the contrast, had a significantly higher MVD count than those which reached this point sooner (p = 0.012). The percentage of tumors with vascular invasion or high mitotic index was significantly higher among those showing a low percentage (150%) of enhancement rate (p = 0.016 and p = 0.03, respectively). However, there was a significant and positive association between the mitotic index and the peak of maximum intensity (p = 0.036). Peritumor inflammation was significantly associated with washout curve type III (p = 0.042).

Conclusions: Variations in the early phase of dynamic MRI seem to be associated with parameters indicatives of tumor aggressiveness in breast cancer.

Show MeSH
Related in: MedlinePlus