Role of Ultrafast Dynamic Contrast-Enhanced MRI in Breast Cancer Prognostication: Correlation Between Early Kinetic...

To evaluate whether early kinetic parameters from ultrafast dynamic contrast-enhanced (DCE) MRI correlate with the histopathological and morphological features of tumors.

We retrospectively included 101 women with breast cancer (103 lesions; 85 invasive and 18 in situ) who underwent preoperative ultrafast DCE-MRI using compressed sensing between January 2020 and July 2022. Two radiologists assessed early kinetic parameters, time to enhancement (TTE) and maximum slope (MS), from the time-intensity curves. These were compared with prognostic factors.

TTE was significantly shorter in tumors ≥2 cm (p = 0.001), invasive carcinomas (vs. carcinoma in situ; p = 0.003), estrogen receptor-negative tumors (p = 0.044), tumors with axillary lymph node metastasis (p = 0.021), and histological grade 3 tumors (vs. grade 1/2; p = 0.029). Higher MS was associated with tumors ≥2 cm (p = 0.008) and invasive carcinomas (p = 0.007). Multivariate regression confirmed tumor size ≥2 cm (p = 0.004 for TTE, p = 0.010 for MS) and invasive carcinoma (p = 0.012 for TTE, p = 0.015 for MS) as independent predictors of shorter TTE and higher MS. Inter-reader agreement for TTE and MS measurements was excellent, with intraclass correlation coefficient values of 0.951 and 0.879, respectively.

Early kinetic parameters from ultrafast DCE-MRI strongly correlated with certain clinicopathological prognostic factors of breast cancer.