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Clinical Article
Study on the correlation between multi-parameter MRI and pathology in the tumor body and peritumoral area of breast cancer
ZHOU Shihao  WANG Xuejia  CHENG Sijia  ZHOU Fengmei  HAN Dongming 

Cite this article as: ZHOU S H, WANG X J, CHENG S J, et al. Study on the correlation between multi-parameter MRI and pathology in the tumor body and peritumoral area of breast cancer[J]. Chin J Magn Reson Imaging, 2023, 14(3): 72-80. DOI:10.12015/issn.1674-8034.2023.03.013.

[Abstract] Objective To explore the differential diagnosis value of amino proton transfer (APT) imaging and diffusion kurtosis imaging (DKI) alone and in combination in the differential diagnosis of benign and malignant breast lesions, and analyze the correlation between peritumoral parameters and pathological factors of breast cancer.Materials and Methods A retrospective analysis was performed on 56 case data of patients with breast lesions. Dynamic contrast-enhanced (DCE) MRI, diffusion weighted imaging (DWI), APT and DKI scans were performed before operation, and the magnetization transfer ratio asymmetry (MTRasym) and mean kurtosis (MK), mean diffusivity (MD), and the apparent diffusion coefficient (ADC) value and the Breast Imaging Reporting and Data System (BI-RADS) classification of the lesion were recorded. The differences in parameters between the benign and malignant groups were compared and analyzed, the combined diagnostic model was established by logistic regression analysis, and the receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of different parameters and the combined model for benign and malignant breast lesions. The ratios of tumor peritumor to tumor body MTRasymp/t, MKp/t, MDp/t, peritumoral and contralateral normal glands MTRasymp/n, MKp/n, MDp/n of each parameter were calculated respectively, and compared differences among groups of different pathological factors.Results The MK value of the malignant group was higher than that of the benign group, and the ADC, MD and MTRasym values were lower than those of the benign group, and the differences were statistically significant (P<0.05). The area under the curves (AUCs) of ADC, MK, MD, MTRasym, DCE, DCE+ADC, DCE+ADC+DKI+APT in diagnosing benign and malignant breast lesions were 0.819, 0.914, 0.895, 0.752, 0.744, 0.886, 0.985. The AUCs of MK and MD were significantly higher than that of DCE, the AUC of MK was significantly higher than that of MTRasym, the AUC of DCE+ADC+DKI+APT were significantly higher than that of other parameters (P<0.05). The results of peritumoral parameter analysis showed that MKp/t has weak negative correlation with HER-2 state (r=-0.365, P=0.043), MKp/t has moderate negative correlation with Ki-67 expression (r=-0.404, P=0.024), MDp/t has moderate positive correlation with Ki-67 expression (r=0.420, P=0.019), MKp/n has weak positive correlation with lymphatic vascular invasion (LVI) (r=0.382, P=0.034), MDp/n has weak negative correlation with LVI (r=-0.373, P=0.039), MKp/n has weak positive correlation with histological grade (r=0.376, P=0.043).Conclusions Both APT and DKI showed high diagnostic efficiency in differentiating benign and malignant breast lesions, and the diagnostic efficiency of multi-parameter combined application was significantly improved. DKI parameters can indicate the impact of breast cancer with different pathological factors on the peritumoral area. Therefore, APT and DKI technology can provide assistance for the diagnosis of breast cancer, the assessment of tumor invasiveness and the formulation of treatment plan.
[Keywords] breast neoplasms;amino proton transfer imaging;diffusion kurtosis imaging;peritumoral area;pathological factors;magnetic resonance imaging

ZHOU Shihao   WANG Xuejia   CHENG Sijia   ZHOU Fengmei   HAN Dongming*  

Department of MRI, the First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China

Corresponding author: Han DM, E-mail:

Conflicts of interest   None.

ACKNOWLEDGMENTS Medical Science and Technological Project of Henan Province (No. 2018020367); Medical Research Development Fund Project of Beijing Kangmeng Charity Foundation (No. B21145AN).
Received  2022-10-21
Accepted  2023-02-25
DOI: 10.12015/issn.1674-8034.2023.03.013
Cite this article as: ZHOU S H, WANG X J, CHENG S J, et al. Study on the correlation between multi-parameter MRI and pathology in the tumor body and peritumoral area of breast cancer[J]. Chin J Magn Reson Imaging, 2023, 14(3): 72-80. DOI:10.12015/issn.1674-8034.2023.03.013.

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