The use of dynamic contrast enhanced MRI in differentiating between benign and malignant breast tumors and predicting the histologic grade for breast cancer patients / 中华放射学杂志

ABSTRACT

Objective To evaluate whether dynamic contrast enhanced-MRI (DCE-MRI) can help clinicians in differentiating malignant tumors from benign lesions and in predicting and correlating the histologic grade for breast cancer patients.Methods DCE-MRI from 98 patients (with histopathological confirmation) in our department were retrospectively analyzed.In the first dynamic phase,the hot and cold spot ROIs were selected as the regions with maximum and minimum Slopein,respectively.The kinetic characteristics (including hot spot,cold spot,and heterogeneous characteristics) and morphologic features were evaluated.The ROC curve analysis was used to test the diagnostic power of all DCE-MRI parameters (inflow slope,Slopein ; washout slope; inflow slope ratio; washout slope ratio; time-signal intensity curve shape; rim enhancement; internal homogeneity) for differentiating malignant tumors from benign breast lesions.Joncheere-Terpstra test was adopted to analyze the kinetic data.Categorical data were analyzed by using the Fisher test.Results Hot spot Slopein might have the biggest area (0.620) under the ROC curve (but not significant) among all the different MRI parameters(P ＞ 0.05).Its sensitivity,specificity,positive predictive value,negative predictive value were 63.2％ (55/87) and 72.7％ (8/11),respectively.The cold spot parameter Slopein(P =0.025),heterogeneity parameter ratio-in (P =0.031),and internal homogeneity (P =0.032) showed a significant correlation with histologic grade.The median and quartile of cold spot Slopein in pathologic Ⅰ,Ⅱ,and Ⅲ were 6.1 × 10-3,5.4 × 10-3 and 1.4 × 10-3,respectively;inflow slope ratio:6.6,9.8 and 17.6 ; pathologic Ⅰ,Ⅱ,and Ⅲ showed 2,1,and 0 patients with homogeneity enhancement,respectively ; intermediate enhancement:5,12,and 2 patients,respectively;heterogeneity enhancement:2,6,and 8 patients.Conclusions The DCE-MRI is a potential tool in helping clinicians to predict the histologic grading in breast cancers.Parameter hot spot Slopein might help differentiae malignant tumors from the benign counterpart.