The volumetric-tumour histogram-based analysis of intravoxel incoherent motion and non-Gaussian diffusion MRI: association with prognostic factors in HER2-positive breast cancer

• Published in: Journal of translational medicine Vol. 17; no. 1; p. 182
• Main Authors: You, Chao, Li, Jianwei, Zhi, Wenxiang, Chen, Yanqiong, Yang, Wentao, Gu, Yajia, Peng, Weijun
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 02.07.2019; BioMed Central; BMC
• Subjects: Biological markers; Breast cancer; Cancer metastasis; Cancer patients; Development and progression; Epidermal growth factors; HER2-positive; Histogram-based analysis; Hormones; Intravoxel incoherent motion; Magnetic resonance imaging; Medical imaging equipment; Medical research; Methods; Non-Gaussian diffusion; Pertuzumab; Prognosis; Tumors; China; Breast cancer; Histogram-based analysis; Non-Gaussian diffusion; HER2-positive; Intravoxel incoherent motion
• ISSN: 1479-5876; 1479-5876
• DOI: 10.1186/s12967-019-1911-6

To evaluate the imaging biomarkers of human epidermal growth factor receptor 2 (HER2) positive breast cancer in comparison to other molecular subtypes and to determine the feasibility of identifying hormone receptor (HR) status and lymph node metastasis status using volumetric-tumour histogram-based analysis through intravoxel incoherent motion (IVIM) and non-Gaussian diffusion. This study included 145 breast cancer patients with 148 lesions between January and November in 2018. Among the 148 lesions, 74 were confirmed to be HER2-positive. The volumetric-tumour histogram-based features were extracted from the combined IVIM and non-Gaussian diffusion model. IVIM and non-Gaussian diffusion parameters obtained from images of the subjects with different molecular prognostic biomarker statuses were compared by Student's t test or the Mann-Whitney U test. The area under the curve (AUC), sensitivity, and specificity at the best cut-off point were reported. The Spearman correlation coefficient was calculated to analyse the correlations of clinical tumor nodule metastasis (TNM) stage and Ki67 with the IVIM and non-Gaussian diffusion parameters. The entropy of mean kurtosis (MK) was significantly higher in the HER2-positive group than in the HER2-negative group (p = 0.015), with an AUC of 0.629 (95% CI 0.546, 0.707), a sensitivity of 62.6%, and a specificity of 66.2%. For HR status, the MD 5th percentile was higher in the HR-positive group of HER2-positive breast cancer (p = 0.041), with an AUC of 0.643 (95% CI 0.523, 0.751), while for lymph node status, the entropy of mean diffusivity (MK) was lower in the lymph node positive group (p = 0.040), with an AUC of 0.587 (95% CI 0.504, 0.668). The clinical TNM stage and Ki67 index were correlated with several histogram parameters. Volumetric-lesion histogram analysis of IVIM and the non-Gaussian diffusion model can be used to provide prognostic information about HER2-positive breast cancers and potentially contribute to individualized anti-HER2 targeted therapy plans .