Correlation Between Multiparametric Dynamic Enhanced Magnetic Resonance Imaging Features Of Breast And Breast Cancer Proliferation Factor Ki-67 At Different Thresholds

Objective:Under different threshold settings,he quantitative parameters of breast DCE-MRI(volume transfer constant(K^trans),rate constant(K_ep),extravascular extracellular volume fraction（V_e）and apparent diffusion coefficient（ADC）value)and MRI image features（tumor volume,BI-RADS dictionary,presence or absence of peripheral edema and internal necrosis）were explored associated with Ki-67.Materials and Methods:Through retrospective research,108 patients diagnosed with breast cancer and directly operated on in our hospital from 2019 to 2022 were collected and clinical data were obtained,lesions were delineated and measured,MRI image characteristics of tumors were obtained,and the maximum,minimum,mean and standard deviation of the relevant MR quantitative parameters(K^trans、K_ep、V_e、ADC)were calculated.Chi-square test or fisher exact test was used to compare the correlation between MR quantitative parameters and Ki-67,and Spearman correlation analysis was used to compare the correlation between MRI image features and Ki-67.Taking 14%,20%and30%as the thresholds of Ki-67,the independent risk factors associated with Ki-67 were screened by multivariate logistic regression analysis and a joint diagnostic model was established respectively,and the receiver operating characteristic（ROC）curve and area under curve（AUC）were used to evaluate the prediction model.Result:The results of multivariate logistic regression analysis showed that when the threshold of Ki-67 was taken as 14%,the short diameter（OR=1.225,95%CI:1.096～1.370）was the independent correlation parameter of Ki-67（P<0.05）.When the Ki-67 threshold is taken by 20%,V_e（STD）（OR=0.006,95%CI:0.001～0.019）and maximum diameter（OR=1.093,95%CI:1.047～1.141）are independent correlation parameters of Ki-67（P<0.05）;When the Ki-67 threshold was taken by 30%,the lesion type（OR=3.005,95%CI:1.055～8.561）,the enhancement type（OR=7.346,95%CI:1.307～41.284）,TIC curve delay phase（OR=5.287,95%CI:1.458～19.175）,maximum diameter（OR=1.040,95%CI:1.006～1.076）,V_e（AV）（OR=0.015,95%CI:0.001～0.332）is an independent correlation parameter of Ki-67（P<0.05）.Among the three prediction models,the prediction model constructed based on DCE-MRI imaging parameters had the highest diagnostic performance when 30%was used as the Ki-67 threshold,with a specificity of80.00%,a sensitivity of 81.58%,a Yordon index of 61.58%,and an AUC of 0.840.Conclusion:When 30%was used as the Ki-67 threshold,the joint imaging features constructed based on DCE-MRI had the highest diagnostic performance and the highest correlation with Ki-67 expression.