Histogram analysis of quantitative pharmacokinetic parameters on DCE-MRI: correlations with prognostic factors and...

Breast cancer heterogeneity influences poor prognoses thorough therapy resistance. This study quantitatively evaluated intratumoral heterogeneity through a histogram analysis of dynamic contrast-enhanced MRI (DCE-MRI) pharmacokinetic parameters, and determined correlations with prognostic factors and molecular subtypes.

We retrospectively investigated 101 invasive ductal breast cancers from 99 women who underwent preoperative DCE-MRI between July 2012 and November 2014. Pharmacokinetic parameters (K^trans, k_ep, and v_e) were obtained by the Tofts model. For each parameter, the mean, standard deviation, coefficient of variation, skewness, and kurtosis values of tumor were calculated, and prognostic factors and subtypes associations were assessed.

The mean of v_e was lower in cancers with high Ki-67 than in cancers with low Ki-67 (P = 0.002). The coefficient of variation of v_e was higher in cancers with estrogen receptor negativity than in cancers with estrogen receptor positivity (P < 0.001). The coefficient of variation of v_e was also higher in cancers with high Ki-67 than in cancers with low Ki-67 (P < 0.001). The skewness of v_e was higher in cancers with high nuclear grade than in cancers with low nuclear grade (P = 0.006). Triple-negative cancers showed higher v_e coefficient of variation than did those with luminal A (P < 0.001) and B (P = 0.006).

Various v_e parameters correlated with breast cancer prognostic factors and molecular subtypes.