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Vascular characterisation of triple negative breast carcinomas using dynamic MRI

  • Breast
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Abstract

Objectives

Triple-negative (ER-/PR-/HER2-) breast carcinomas (TNBC) are aggressive tumours with underexplored imaging features. This study investigates whether their vascular characteristics as assessed by dynamic contrast-enhanced (DCE) and dynamic susceptibility contrast-enhanced (DSC) MRI are distinct from the prognostically more favourable ER+/PR+/HER2- cancers.

Methods

Patients with primary breast cancer underwent MRI before neoadjuvant chemotherapy and were identified as ER-/PR-/HER2- or ER+/PR+/HER2- from core biopsy specimens. MRI parameters reflecting tissue perfusion, permeability, and extracellular leakage space were measured. Values for inflow transfer constant (Ktrans), outflow rate constant (kep), leakage space (ve), area under the gadolinium curve (IAUGC60 ), relative blood volume (rBV) and flow (rBF), and Mean Transit Time (MTT) were compared across receptor status and with known prognostic variables.

Results

Thirty seven patients were assessable in total (16 ER-/PR-/HER2-, 21 ER+/PR+/HER2-). Lower ve (p = 0.001), shorter MTT (p = 0.007) and higher kep values (p = 0.044) were observed in TNBC. ve was lower across all T stages, node-negative (p = 0.004) and low-grade TNBC (p = 0.037). ve was the best predictor of triple negativity (ROC AUC 0.80).

Conclusions

TNBC possess characteristic features on imaging, with lower extracellular space (higher cell density) and higher contrast agent wash-out rate (higher vascular permeability) suggesting a distinctive phenotype detectable by MRI.

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Abbreviations

bFGF:

Basic fibroblast growth factor

CALGB:

Cancer and Leukemia group B

DCE-MRI:

Dynamic contrast-enhanced MRI

DSC-MRI:

Dynamic susceptibility contrast-enhanced MRI

ECM:

Extracellular matrix

ER:

Oestrogen receptor

FISH:

Fluorescence in-situ hybridisation

Gd-DTPA:

Gadopentetate dimeglumine

HER2:

Human epidermal growth factor receptor-2

IAUGC60 :

Initial area under the gadolinium curve after the first 60 s

kep :

Outflow rate constant

Ktrans :

Inflow transfer constant

MRI:

Magnetic resonance imaging

MTT:

Mean transit time

NAC:

Neoadjuvant chemotherapy

PET-CT:

Positron emission tomography-computed tomography

PR:

Progesterone receptor

rBF:

Relative blood flow

rBV:

Relative blood volume

ROC:

Receiver operating curve characteristic

TE:

Echo time

TNBC:

Triple-negative breast carcinomas

TNM:

Tumour, node, metastasis

TR:

Repetition time

ve :

Leakage space

VEGF:

Vascular endothelial growth factor

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Acknowledgements

This study was supported by a grant from the Breast Cancer Research Trust, United Kingdom.

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Authors and Affiliations

  1. Academic Oncology Unit, Mount Vernon Cancer Centre, Northwood, Middlesex, HA6 2RN, UK

    Sonia P. Li, Mark J. Beresford, Mei-Lin W. Ah-See & Andreas Makris

  2. Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, Middlesex, HA6 2RN, UK

    Anwar R. Padhani, N. Jane Taylor & J. James Stirling

  3. CR UK and EPSRC Cancer Imaging Centre, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, Surrey, SM2 5PT, UK

    James A. d’Arcy & David J. Collins

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  1. Sonia P. Li
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Correspondence to Sonia P. Li.

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Li, S.P., Padhani, A.R., Taylor, N.J. et al. Vascular characterisation of triple negative breast carcinomas using dynamic MRI. Eur Radiol 21, 1364–1373 (2011). https://doi.org/10.1007/s00330-011-2061-2

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  • DOI: https://doi.org/10.1007/s00330-011-2061-2

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