Preoperative prediction of extensive intraductal component in invasive breast cancer based on intra- and peri-tumoral heterogeneity in high-resolution ultrafast DCE-MRI.

Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE

Original Publication: London : Nature Publishing Group, copyright 2011-

Magnetic Resonance Imaging*/methods ; Breast Neoplasms*/diagnostic imaging ; Breast Neoplasms*/surgery ; Breast Neoplasms*/pathology; Humans ; Female ; Middle Aged ; Retrospective Studies ; Aged ; Adult ; Neoplasm Invasiveness ; Preoperative Care/methods

Preoperatively predicting extensive intraductal component in invasive breast cancer through imaging is crucial for informed decision-making, guiding surgical planning to mitigate risks of incomplete resection or re-operation for positive margins in breast-conserving surgery. This study aimed to characterize intra- and peri-tumor heterogeneity using high-spatial resolution ultrafast DCE-MRI to predict the extensive intraductal component in invasive breast cancer (IBC-EIC) preoperatively. A retrospective analysis included invasive breast cancer patients who underwent preoperative high-spatial resolution ultrafast DCE-MRI, categorized based on intraductal component status (IBC-EIC vs. IBC without EIC). Propensity score matching (PSM) was employed to balance clinicopathological covariates between the groups. Personalized kinetic intra-tumor heterogeneity (ITH ^kinetic ) and peri-tumor heterogeneity (PTH ^kinetic ) scores were quantified using clustered voxels with similar enhancement patterns. An image combined model, incorporating MRI features, ITH ^kinetic , and PTH ^kinetic scores, was developed and assessed. Of 368 patients, 26.4% (97/368) had IBC-EIC. PSM yielded well-matched pairs of 97 patients each. After PSM, ITH ^kinetic and PTH ^kinetic scores were significantly higher in the IBC-EIC group (ITH ^kinetic : 0.68 ± 0.23; PTH ^kinetic : 0.58 ± 0.19) compared to IBC without EIC (ITH ^kinetic : 0.32 ± 0.25; PTH ^kinetic : 0.42 ± 0.18; p < 0.001). Before PSM, ITH ^kinetic (0.71 ± 0.20 vs. 0.49 ± 0.28, p < 0.001) and PTH ^kinetic (0.61 ± 0.18 vs. 0.50 ± 0.20, p < 0.001) scores remained higher in the IBC-EIC group. The Image Combined Model demonstrated good predictive performance for IBC-EIC, with an AUC of 0.91 (95% CI 0.86-0.95) after PSM and 0.85 (95% CI 0.81-0.90) before PSM. Inclusion of ITH ^kinetic and PTH ^kinetic scores significantly improved prediction capability. ITH ^kinetic and PTH ^kinetic characterization from high-spatial resolution ultrafast DCE-MRI kinetic curves enhances preoperative prediction of IBC-EIC, offering valuable insights for personalized breast cancer management.
(© 2024. The Author(s).)

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YXJL-2023-0227-0066 Beijing Medical Award Foundation; U21A20521 Joint Funds of the National Natural Science Foundation of China

Keywords: Breast neoplasms; Ductal carcinoma in situ; Magnetic resonance imaging

Date Created: 20240729 Date Completed: 20240729 Latest Revision: 20240806

20250114

PMC11286762

10.1038/s41598-024-68601-6

39075278