The Forecast Value Of Dynamic Contrast-Enhanced MRI Combined With DWI For Molecular Subtypes Of Breast Cancer

Objective: Different molecular subtypes of breast cancer have differences in clinical biological behavior and prognosis.Therefore,this study explores the value of MRI dynamic enhancement parameters combined with ADC values to predict the molecular subtypes of breast cancer.Wishing these parameters can predict molecular subtypes by non-invasive imaging methods,and than providing a preliminary assessment of clinical treatment and prognosis.Methods: Patients who were diagnosed with invasive breast cancer after surgery in the Affiliated Hospital of Qinghai University from September 2016 to December 2018 were enrolled.MRI was performed before the operation,and no anti-tumor treatment was performed before MRI scan and surgery.Patients were divided into Luminal A-like type(group A),Luminal B-like type(group B),ERBB2+ type(group E),and Triple-negative type(group T)according to the immunohistochemical index(ER,PR,Her-2,Ki-67).MRI dynamic contrast-enhanced and DWI image post-processing are processed by using the Philips Achieva MRI post-processing analysis software,the ADC value,time-signal intensity curve(TIC)and related parameters were measured,and than statistically analyzed the obtained data.Results: A total of 141 people were enrolled in this study,including 1 male and 140 female.This subject includes a total of 148 cases of lesions,32 in group A,74 in group B,32 in group E,and 10 in group T.The pathological types of these patients are invasive breast cancer.The result of image shows: the ADC values of group T were lower than that of the other three groups and the difference was statistically significant(P<0.05).There were significant differences in the TIC types between the four groups(P<0.05).The ME value was lower in the B group and higher in the E group,the TTP value of group E was lower than that of the other three groups,and the WIR value of group T was higher than that of the other three groups,all of the difference was statistically significant(P<0.05).Moreover,the forecast shows: the sensitivity of using ME value to predict group B was 16.22%,the specificity was 98.65%,and the diagnostic accuracy was 61.59%.The sensitivity of using ME and TTP predict group E was 43.75%,the specificity was 91.38%,and the diagnostic accuracy was 86.96%;The sensitivity of using ADC and WIR predict group T was 60%,the specificity was 48.55%,and the diagnostic accuracy was 52.90%.Conclusion: MRI dynamic contrast-enhanced of breast cancer and DWI parameters such as ADC,ME,TTP,WIR,etc.have significant differences among the four molecular subtypes,group B has a lower ME value,group E has a higher ME value and a lower TTP value,and group T has a lower ADC value and a higher WIR value.Different parameters have predictive value for breast cancer molecular subtypes,especially for triple-negative breast cancer,but the diagnostic efficiency is not certain,which can not be used for clinical diagnosis,at present.