Dynamic Contrast-enhanced MR Imaging,diffusion-weighted Imaging Of Breast Cancers:correlation With Cell Proliferation Activity

Objective: The purpose of the exploratory study is to evaluate the association ofdynamic contrast-enhanced MR imaging(DCE-MRI),diffusion-weighted imaging(DWI) of breast cancer with cell proliferation biomarkers (PCNA,Ki-67).Methods:34patiens confirmed with breast cancer underwent MR examinationson1.5T scanner(GE,HD)preoperatively.MR examinations included8-12min3DDEC-MRI by VIBRANT sequence,DWI with b value of0,800s/mm2by single-shotEPI sequence.Contrast agent Gd-DTPA was injected with bolus and was followedwith a20ml flush of isotonic saline solution.Morphological and kinetic MR featureswere determined based on the breast imaging and reporting data system (BI-RADS)MR imaging lexicon.The mean apparent diffusion coefficients(ADC) of the lesionswas calculated on DWI with b value of800s/mm2.The mastectomy specimens of34maligent breast lesions expression of PCNA,Ki-67were measured byimmunohistochemical staining.The MR features(morphological,TIC,early phaseenhancement ratio,time to peak,ADC value) were correlated withimmunohistochemical detected biomarkers of cell proliferation.Correlations betweenthe MR featues and cell proliferation were determined using Spearman correlationcoefficients,non-parametric rank methods(Wilcoxon and Kruskal-Wallis H tests),ttest,X2test and the Fisher’s Exact test.Result:Among34patients,histology revealed invasive ductal carcinoma24patients (70.6%); Invasive lobular carcinoma4cases,11.8%; Ductal carcinoma in2cases,5.9%; Squamous cell carcinoma in2cases,5.9%; Neuroendocrine carcinomain1patient,2.9%; The cancer glioblastoma in1patient,2.9%.There were31PCNApositive(91.2%),15Ki-67positive(44.1%). The early-phase enhancement ratio of breast cancer and PCNA expression was positively correlated(r=0.406，P＜0.05);when b=800s/mm2,the ADC value and posi tive expression of PCNA has anegative correlation (r=－0.392，P＜0.05).Conclusion: Breast DCE-MRI some hemodynamic parameters and ADC valuesseem to be associated with PCNA expression in breast cancer, these parameters maypredict cell proliferation high activity,help to diagnose breast cancer,and evaluate theeffection of neoadjuvant chemotherapy.