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Peritumor to tumor apparent diffusion coefficient ratio is associated with biologically more aggressive breast cancer features and correlates with the prognostication tools.
PLoS One. 2020; 15(6):e0235278.Plos

Abstract

PURPOSE

The apparent diffusion coefficient (ADC) is increasingly used to characterize breast cancer. The peritumor/tumor ADC ratio is suggested to be a reliable and generally applicable index. However, its overall prognostication value remains unclear. We aimed to evaluate the associations between the peritumor/tumor ADC ratio and histopathological biomarkers and published prognostic tools in patients with invasive breast cancer.

MATERIALS AND METHODS

This prospective study included 88 lesions (five bilateral) in 83 patients with primary invasive breast cancer who underwent preoperative 3.0-T magnetic resonance imaging. The lowest intratumoral mean ADC value on the slice with the largest tumor cross-sectional area was designated the tumor ADC, and the highest mean ADC value on the peritumoral breast parenchymal tissue adjacent to the tumor border was designated the peritumor ADC. The peritumor/tumor ADC ratio was then calculated. The tumor and peritumor ADC values and peritumor/tumor ADC ratios were compared with histopathological parameters using an unpaired t test, and their correlations with published prognostic tools were evaluated with Pearson's correlation coefficient.

RESULTS

The peritumor/tumor ADC ratio was significantly associated with tumor size (p<0.001), histological grade (p = 0.005), Ki-67 index (p = 0.006), axillary-lymph-node metastasis (p = 0.001), and lymphovascular invasion (p = 0.006), but was not associated with estrogen receptor status (p = 0.931), progesterone receptor status (p = 0.160), or human epidermal growth factor receptor 2 status (p = 0.259). The peritumor/tumor ADC ratio showed moderate positive correlations with the Nottingham Prognostic Index (r = 0.498, p<0.001) and mortality predicted using PREDICT (r = 0.436, p<0.001).

CONCLUSION

The peritumor/tumor ADC ratio was correlated with histopathological biomarkers in patients with invasive breast cancer, showed significant correlations with published prognostic indexes, and may provide an easily applicable imaging index for the preoperative prognostic evaluation of breast cancer.

Authors+Show Affiliations

Institute of Clinical Medicine, School of Medicine, Clinical Radiology, University of Eastern Finland, Kuopio, Finland. Department of Clinical Radiology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.Institute of Clinical Medicine, School of Medicine, Clinical Radiology, University of Eastern Finland, Kuopio, Finland. Department of Clinical Radiology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.Institute of Clinical Medicine, School of Medicine, Oncology, University of Eastern Finland, Kuopio, Finland. Department of Oncology, Cancer Center, Kuopio University Hospital, Kuopio, Finland.Institute of Clinical Medicine, School of Medicine, Clinical Radiology, University of Eastern Finland, Kuopio, Finland. Department of Clinical Radiology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.Institute of Clinical Medicine, School of Medicine, Clinical Radiology, University of Eastern Finland, Kuopio, Finland. Department of Clinical Radiology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.Institute of Clinical Medicine, School of Medicine, Clinical Radiology, University of Eastern Finland, Kuopio, Finland. Department of Clinical Radiology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.Institute of Clinical Medicine, School of Medicine, Pathology and Forensic Medicine, and Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland. Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland.Institute of Clinical Medicine, School of Medicine, Oncology, University of Eastern Finland, Kuopio, Finland. Department of Oncology, Cancer Center, Kuopio University Hospital, Kuopio, Finland.Institute of Clinical Medicine, School of Medicine, Pathology and Forensic Medicine, and Translational Cancer Research Area, University of Eastern Finland, Kuopio, Finland. Biobank of Eastern Finland, Kuopio University Hospital, Kuopio, Finland.Institute of Clinical Medicine, School of Medicine, Clinical Radiology, University of Eastern Finland, Kuopio, Finland. Department of Clinical Radiology, Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32584887

Citation

Okuma, Hidemi, et al. "Peritumor to Tumor Apparent Diffusion Coefficient Ratio Is Associated With Biologically More Aggressive Breast Cancer Features and Correlates With the Prognostication Tools." PloS One, vol. 15, no. 6, 2020, pp. e0235278.
Okuma H, Sudah M, Kettunen T, et al. Peritumor to tumor apparent diffusion coefficient ratio is associated with biologically more aggressive breast cancer features and correlates with the prognostication tools. PLoS ONE. 2020;15(6):e0235278.
Okuma, H., Sudah, M., Kettunen, T., Niukkanen, A., Sutela, A., Masarwah, A., Kosma, V. M., Auvinen, P., Mannermaa, A., & Vanninen, R. (2020). Peritumor to tumor apparent diffusion coefficient ratio is associated with biologically more aggressive breast cancer features and correlates with the prognostication tools. PloS One, 15(6), e0235278. https://doi.org/10.1371/journal.pone.0235278
Okuma H, et al. Peritumor to Tumor Apparent Diffusion Coefficient Ratio Is Associated With Biologically More Aggressive Breast Cancer Features and Correlates With the Prognostication Tools. PLoS ONE. 2020;15(6):e0235278. PubMed PMID: 32584887.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Peritumor to tumor apparent diffusion coefficient ratio is associated with biologically more aggressive breast cancer features and correlates with the prognostication tools. AU - Okuma,Hidemi, AU - Sudah,Mazen, AU - Kettunen,Tiia, AU - Niukkanen,Anton, AU - Sutela,Anna, AU - Masarwah,Amro, AU - Kosma,Veli-Matti, AU - Auvinen,Päivi, AU - Mannermaa,Arto, AU - Vanninen,Ritva, Y1 - 2020/06/25/ PY - 2020/02/13/received PY - 2020/06/12/accepted PY - 2020/6/26/entrez PY - 2020/6/26/pubmed PY - 2020/6/26/medline SP - e0235278 EP - e0235278 JF - PloS one JO - PLoS ONE VL - 15 IS - 6 N2 - PURPOSE: The apparent diffusion coefficient (ADC) is increasingly used to characterize breast cancer. The peritumor/tumor ADC ratio is suggested to be a reliable and generally applicable index. However, its overall prognostication value remains unclear. We aimed to evaluate the associations between the peritumor/tumor ADC ratio and histopathological biomarkers and published prognostic tools in patients with invasive breast cancer. MATERIALS AND METHODS: This prospective study included 88 lesions (five bilateral) in 83 patients with primary invasive breast cancer who underwent preoperative 3.0-T magnetic resonance imaging. The lowest intratumoral mean ADC value on the slice with the largest tumor cross-sectional area was designated the tumor ADC, and the highest mean ADC value on the peritumoral breast parenchymal tissue adjacent to the tumor border was designated the peritumor ADC. The peritumor/tumor ADC ratio was then calculated. The tumor and peritumor ADC values and peritumor/tumor ADC ratios were compared with histopathological parameters using an unpaired t test, and their correlations with published prognostic tools were evaluated with Pearson's correlation coefficient. RESULTS: The peritumor/tumor ADC ratio was significantly associated with tumor size (p<0.001), histological grade (p = 0.005), Ki-67 index (p = 0.006), axillary-lymph-node metastasis (p = 0.001), and lymphovascular invasion (p = 0.006), but was not associated with estrogen receptor status (p = 0.931), progesterone receptor status (p = 0.160), or human epidermal growth factor receptor 2 status (p = 0.259). The peritumor/tumor ADC ratio showed moderate positive correlations with the Nottingham Prognostic Index (r = 0.498, p<0.001) and mortality predicted using PREDICT (r = 0.436, p<0.001). CONCLUSION: The peritumor/tumor ADC ratio was correlated with histopathological biomarkers in patients with invasive breast cancer, showed significant correlations with published prognostic indexes, and may provide an easily applicable imaging index for the preoperative prognostic evaluation of breast cancer. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/32584887/Peritumor_to_tumor_apparent_diffusion_coefficient_ratio_is_associated_with_biologically_more_aggressive_breast_cancer_features_and_correlates_with_the_prognostication_tools L2 - https://dx.plos.org/10.1371/journal.pone.0235278 DB - PRIME DP - Unbound Medicine ER -
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