| Objective:The quantitative parameters and histogram parameters of dynamic contrast enhanced magnetic resonance imaging((Dynamic contrast enhanced magnetic resonance imaging,DCE-MRI)and its histogram parameters,the apparent diffusion coefficient((Apparent Diffusion Coefficient,ADC)of magnetic resonance diffusion weighted imaging((Diffusion weighted imaging,DWI)and the quantitative parameters of incoherent motion imaging((Intravoxel incoherent motion,IVIM)in voxels of breast cancer were analyzed by dynamic contrast enhanced magnetic resonance imaging(MRI)and its histogram parameters.To investigate the correlation between the quantitative parameters of DCE-MRI and IVIM and their histogram parameters and the immunohistochemical indexes of breast cancer,such as estrogen receptor(Estrogen receptor,ER),progesterone receptor(Progestrone receptor,PR),human epidermal growth factor receptor-2((Human epidermal growth factor receptor-2)and value-added index(Ki67).To provide basis for early treatment of various types of breast cancer.Materials and methods:A total of 60 female patients with breast cancer(62 lesions)who underwent br east MRI examination in the affiliated Hospital of Shandong University of traditiona 1 Chinese Medicine from October 2018 to October 2020 were collected.All lesions were confirmed by intraoperative frozen section and later pathology,and immunohis tochemical analysis was performed after operation.Before MRI,all patients were n ot treated with fine needle aspiration or elastic gun puncture,chemotherapy and rad iotherapy.The age range of the patients ranged from 34 to 65 years old,with an a verage age of(42.68 ±8.06)years.The image was scanned by GE1.5T nuclear mag netic resonance scanner with 4-channel bilateral breast phase control line coil.Conv entional MRI sequences included axial T1WI,T2STIR and bilateral sagittal T2FSE.DWI scan sequence includes conventional double b-value(0,1000s/mm2)EPI seque nce and axial multi-b-value(IVIM)FSE sequence.Subsequently,VIBRANT technol ogy was used to perform 3D dynamic multi-phase scanning.All the scanned images are transferred to the GEADW4.6 workstation for post-processing.The DCE-MRI i mage is imported into GeniQ software to process the quantitative parameters Kep,Ktrans and ve.The ADC values of lesions on conventional DWI images were meas ured and IVIM images were imported into MADC software to obtain pure diffusion coefficient(Purediffusioncoefficient,Dslow),perfusion-related diffusion coefficient(Pse udodiffusioncoefficient,Dfast)and perfusion fraction(Perfusionfraction,f).Then the m ean(mean),minimum(minimum),maximum(maximum),10th percentile(10th),25t h percentile(25th),50th percentile(50th),75th percentile(75th),90th percentile(90 th),skewness(skewness)and kurtosis(kurtosis)of each quantitative parameter were obtained by histogram analysis.The expression of ER,PR,HER-2 and Ki67 in eac h breast cancer lesion was recorded.SPSS23.0 software was used for statistical anal ysis,all measurement data were tested by normal distribution,and those in accorda nce with normal distribution were expressed by mean ±standard deviation.Spearman rank correlation analysis was used to analyze the correlation between the parameters and the expression of ER,PR,HER-2 and Ki67 in breast cancer.Results:1.Correlation analysis between DCE-MRI quantitative parameters and the expression of ER,PR,HER-2 and Ki67 in breast cancer.Ktrans and Kep values were negatively correlated with the expression of ER and PR,and the absolute correlation coefficient between KT value and ER expression was the highest(r=0.371),but had no significant correlation with Ve value(p>0.05).There was a negative correlation between the Kep value and the expression of Her-2.There was no significant correlation between the value of VE and the expression of Her-2(p>0.05),and there was no significant correlation between the value of),Ktrans and the expression of Her-2.There was a positive correlation between Ktrans value and Ki67 expression(r=0.264,P<0.01).There was no significant correlation between VE value and Ki67 expression(p>0.05).two.2.Analysis of correlation between DCE-MRI quantitative histogram parameters and ER,PR,HER-2,Ki67 expression in breast cancer2.1 The correlation between breast cancer immunohistochemical index ER and DCE-MRI quantitative histogram parameters showed that Kep value(mean,minimum,50%bit value),Vee value(minimum value,10%bit value)were negatively correlated with ER expression.(P<0.05)and had the strongest correlation with the ve value(10%digit value)(r=0.358,P<0.01).There was no correlation between other histogram parameters and ER expression.2.2correlation between PR and DCE-MRI quantitative histogram parameters in breast cancer results Kep values(mean,minimum,50%,75%)were negatively correlated with PR expression(-0.287,0.308,P<0.05),but there was no correlation between other histogram parameters and PR expression(P>0.05).2.3The correlation between Her-2 and DCE-MRI quantitative histogram parameters showed that Kep value(kurtosis)and Vee value(90%bit value)were positively correlated with Her-2 expression(rang 0.266),and had the strongest correlation with VE value(90%bit value).Other histogram parameters had no correlation with Her-2 expression(P>0.05).The results of correlation between Ki67 and DCE-MRI quantitative histogram parameters showed that Kep value(25%bit value),KTN value(10%bit value,50%bit value),ve value(mean,50%bit value)were positively correlated with Ki67 expression(rust 0.253-0.287 P<0.05i),while Vevalue(kurtosis)was negatively correlated with Ki67 expression.There was no correlation between other histogram parameters and Ki67 expression.3.Correlation analysis between ADC value,IVIM quantitative parameters and the expression of ER,PR,HER-2,Ki67 in breast cancer.There was a negative correlation between ADC,D*,D,f and ER expression.There was a correlation between ADC,D*,D value and PR expression,and the absolute value of correlation between ADC and D value was the highest.There was no significant correlation between ADC,D*,D,f and the expression of Her-2 and Ki67.4.Correlation Analysis of ADC value,IVIM quantitative histogram parameters and the expression of ER,PR,HER-2 and Ki67 in Breast Cancer4.1 the correlation between ER,ADC value and IVIM quantitative histogram parameters showed that ADC value(minimum,skewness,kurtosis),DFT value(mean,maximum value),Dfab value(25%digit value)were positively correlated with the expression of ER.And the absolute value of ADC(minimum)correlation was the highest(r=0.358,p<0.05).The absolute values of Dslow(skewness,kurtosis)and Dfasting(mean,maximum,10%),f(10%,25%)were negatively correlated with the expression of ER(r=-0.375,-0.340,-0.385,p<0.01 respectively),and the absolute correlation between Dfastvalue(skewness,kurtosis)and Dfastvalue(mean value)was the highest(r=-0.375,-0.340,-0.385,p<0.01 respectively),and the absolute correlation between Dfastvalue(skewness,kurtosis)and Dfastvalue(mean value)was the highest(r=-0.375,-0.340,-0.385,p<0.01 respectively).There was no significant correlation between other histogram parameters and ER expression.4.2 The value of ADC(minimum)was positively correlated with the expression of PR(r=0.252,p<0.05respectively).The values of DFT(skewness,kurtosis),DFY(average,10%digit),f(mean,50%)were negatively correlated with the expression of PR(r=0.254,r=0.351,p<0.05).At the same time,the absolute correlation of Dfast(average)was the highest(r=0.351,p<0.01).There was no significant correlation between other histogram parameters and PR expression.4.3The correlation between Her-2 and ADC value and the quantitative histogram parameters of IVIM showed that the ADC value(minimum)was negatively correlated with the expression of Her-2(r=0.313,p<0.05),but there was no significant correlation between other histogram parameters and Her-2 expression(P>0.05).4.4The correlation between Ki67 and ADC value and the quantitative histogram parameters of IVIM in breast cancer showed that there was no significant correlation between the quantitative histogram parameters and the expression of Ki67(P>0.05).Conclusion:Compared with DCE-MRI and IVIM quantitative parameters,histogram analysis can evaluate the physiological,biochemical and hemodynamic changes of breast cancer lesions microscopically,and each quantitative histogram parameters have different degrees of correlation with different immunohistochemical indexes,so we can predict the immunohistochemical indexes of breast cancer lesions to some extent,so as to reflect the heterogeneity of different types of breast cancer tumors.And then provide imaging basis for early accurate treatment of clinical breast cancer. |
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