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Amide Proton Transfer-Weighted Imaging Combined with Fat Fraction Imaging for Diagnosis of Triple-Negative Breast
Xinyue Yin1, Shuo Wang1, Zhitian Guo1
1Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 Zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China (X.Y., S.W., Z.G., M.Z., L.L., L.Z.).
Rationale And Objectives:
To evaluate the diagnostic value of amide proton transfer-weighted imaging (APTw) combined with modified Dixon fat quantitation technique (mDixon-Quant) for differentiating triple-negative breast cancer (TNBC) from non-TNBC.
Materials And Methods:
This retrospective study included 107 breast cancer patients who underwent preoperative MRI with APTw and mDixon-Quant. Based on immunohistochemistry, patients were classified into TNBC (n=24) and non-TNBC (n=83) groups. Two radiologists independently measured APTw, fat fraction (FF), and T2* values. Interobserver consistency was assessed using the intraclass correlation coefficient (ICC). Continuous and categorical variables were compared using the Mann-Whitney U and χ² tests, respectively. Diagnostic performance was evaluated and compared using receiver operating characteristic (ROC) analysis, with the DeLong test for AUC comparisons.
Results:
The TNBC group showed significantly higher Ki-67 index, APTw, and T2* values, but lower FF values than the non-TNBC group (all p<0.05). The combined use of APTw and FF values demonstrated favorable diagnostic efficacy, with an AUC of 0.885. Adding Ki-67 index increased the AUC to 0.911, but the difference was not significant (p>0.05).
Conclusion:
APTw combined with mDixon-Quant provides valuable non-invasive imaging evidence for preoperative TNBC diagnosis, guiding clinical treatment strategies and prognostic assessment.
