Comparation Of The Correlation Of Quantitative Perfusion Parameters On Dynamic Contrast-enhanced MRI And ADC Value With Prognostic Factors And Molecular Subtypes In Breast Cancer

Purpose To compare the association between pharmacokinetic parameters derived from dynamic contrast-enhanced magnetic resonance imaging（DCE-MRI）and apparent diffusion coefficient（ADC）value with pathological prognostic factors proliferation status and immunohistochemical subtypes of breast cancers.Methods This retrospective study population consisted of 127 breast carcinomas between 2012 and 2018 from Zhongda Hospital,Medical School,Southeast University.All patients were operated for the breast mass which were verified by pathology and immunohistochemistry.123 breast lesions were divided into different subtypes based on the immunohistochemical proliferation status.All patients underwent dynamic contrast-enhanced MRI and diffusion weighted imaging and were recorded the perfusion parameters including volume transfer constant(K^trans),rate constant(K_ep),volume of EES per unit volume of tissue（V_e）value,with apparent diffusion coefficient（ADC）value.Recording expressional status of human epidermal growth factor receptor-2（Her-2）,progesterone receptor（PR）,estrogen receptor（ER）and Ki-67,then subtypes were categorized.The association between quantitative perfusion parameters and ADC value with prognostic factors and subtypes of breast cancers were evaluated by using the independent-samples t test or Mann-Whitney U test or the one-way analysis of variance（ANOVA）or Kruskal-Wallis test and Spearman test or the area under ROC curve（AUC）.Results（1）In the ER/PR-positive groups,the K^trans,K_ep and ADC value were significantly lower than that of the ER/PR-negative groups（P<0.05）;V_e and ADC value were higher in tumors with HER-2-positive than HER-2-negative and statistically significance was observed between them（P<0.05）.（2）There was a negative correlation between ER/PR positive and K^trans,K_ep and ADC value,and the correlation between ER positive and Ktrans was most close（r=-0.252）,and the correlation between PR positive and K_epp was most close（r=-0.257）.Ve and ADC value were positively correlated with HER-2,and correlations of them were silimar.There was positively correlated between Ki-67 and Ktrans（r=0.226,P=0.012）.There were no significant correlations between Ki-67 with K_ep,V_e and ADC value respectively（P>0.05）.（3）There was a statistical significance in K^trans,K_ep,V_e and ADC values between different immunohistochemical subtypes（P<0.05）.Compared with other parameters,the area under the ROC curve in the diagnosis of tri-negative breast cancer using the Kep value was the highest,AUC was 0.904,with the most approximately registration index as the cut off point,the sensitivity was 81.8%,and the specificity was 85.7%.Conclusion The pharmacokinetic parameters derived from DCE-MRI and ADC value were associated with the expression of some pathological prognostic factors,and might also be helpful to evaluate the biological progress and prognosis and predict different subtypes,and K_ep value best predictive indicator of tri-negative breast cancer.