Signal Enhancement Ratios (SERs) in Breast Carcinomas Measured by 3D contrast - MRI and Verified by Histopathology

摘要

The goal of this project is the evaluation of a three-point contrast- enhanced magnetic resonance imaging (MRI) technique for characterizing breast carcinoma. We have developed a high resolution method that captures both anatomic heterogeneity as well as differences in contrast uptake pattern, using the signal enhancement ratio (SER). 161 patients have been enrolled to date; 148 of these have had histopathologic correlation. 42 patients with stage III/IV breast cancer underwent pre-operative chemotherapy and received contrast-MRI exams prior to chemotherapy, following 1 cycle, and after completing a full course (4 cycles) of neoadjuvant treatment. We previously reported superior capability of MRI relative to mammography for defining extent of disease in the symptomatic breast, with particular value in cases of multifocal disease or presence of an associated in-situ component. We found a significant correlation between peak SER value and both tumor grade and microvessel density, and demonstrated improved diagnostic specificity of the three-point SER method over a standard two- point static' method. Our recent preliminary results in treated tumors demonstrate that contrast-MRI can accurately assess residual tumor volume. Tumor classification by MRI pattern appears to correlate with clinical response and nodal status. MRI may have value for early prediction of end response, recurrence and survival.