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The diffusion MRI signature index is highly correlated with immunohistochemical status and molecular subtype of invasive breast carcinoma

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Abstract

Objectives

To evaluate the relationship of the signature index (S-index), an advanced diffusion MRI marker, and the immunohistochemical (IHC) status, proliferation rate, and molecular subtype of invasive breast cancers.

Methods

A retrospective study of patients with invasive carcinoma was conducted between 2017 and 2021. All patients underwent dynamic contrast-enhanced MRI and DWI using a 3-T system. For DWI, three b values (0, 200, and 1500 s/mm2) were used to derive the S-index. Three-dimensional ROIs were manually placed over the whole tumor on DWI. Mean and 85th percentile S-index values were compared to the IHC status, proliferation rate, and molecular subtypes of lesions.

Results

The study included 153 patients (mean age, 60 ± 13 years) with 160 invasive carcinomas. S-index values were significantly higher in estrogen receptor–positive (mean, p = .005; 85th percentile, p < .001) and progesterone receptor–positive (mean, p = .003; 85th percentile, p < .001) tumors, and significantly lower in human epidermal growth factor receptor 2 (HER2) – positive tumors (mean, p = .023; 85th percentile, p < .001). Mean and 85th percentile S-index values were significantly different among breast cancer subtypes (mean, p = .015; 85th percentile, p = .002), and the AUC of these values for the prediction of IHC status were 0.64 and 0.66 for HER2, and 0.70 and 0.74 for hormone receptors, respectively.

Conclusions

The DWI S-index showed significantly higher values in invasive carcinomas with immunohistochemical status associated with good prognosis, suggesting its usefulness as a noninvasive imaging biomarker to estimate IHC status and orient treatment.

Key Points

• The signature index, an advanced diffusion MRI marker, showed good discrimination of immunohistochemical status in invasive breast carcinomas.

• The signature index has the potential to differentiate noninvasively invasive breast carcinoma subtypes and appears as an imaging biomarker of prognostic factors and molecular phenotypes

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Abbreviations

ADC:

Apparent diffusion coefficient

AUC:

Area under the curve

DWI:

Diffusion-weighted imaging

DCE:

Dynamic contrast enhanced

ER:

Estrogen receptor

HER2:

Human epidermal growth factor receptor 2

IHC:

Immunohistochemical

IVIM:

Intravoxel incoherent motion

PR:

Progesterone receptor

ROC:

Receiver-operating characteristic

ROI:

Region of interest

S-index:

Signature index

3D:

Three dimensional

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Acknowledgements

We thank Cecilia Garrec for the English language corrections.

Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi Hirokoji, Kamigyoku, Kyoto, 602-8566, Japan

    Mariko Goto, Denis Le Bihan, Koji Sakai & Kei Yamada

  2. Neurospin, CEA-Saclay, Paris-Saclay University, Gif-sur-Yvette, France

    Denis Le Bihan

  3. National Institute for Physiological Sciences, Okazaki, Japan

    Denis Le Bihan

Authors
  1. Mariko Goto
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Corresponding author

Correspondence to Mariko Goto.

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Guarantor

The scientific guarantor of this publication is Mariko Goto, MD, PhD, lecturer of the Department of Radiology, Kyoto Prefectural University of Medicine.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and Biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Some subjects have been included in a previous study which was published in Radiology (reference #23) to introduce and validate the method (S-index) for diagnosis purposes. The present study was performed with a cohort of 153 patients (with 160 lesions), including the 56 invasive breast carcinoma patients (with 60 lesions) included in the previous study, with a different goal (correlation with molecular biomarkers). We have included this important information in the manuscript at the part of “Materials and Methods.”

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

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Goto, M., Le Bihan, D., Sakai, K. et al. The diffusion MRI signature index is highly correlated with immunohistochemical status and molecular subtype of invasive breast carcinoma. Eur Radiol 32, 4879–4888 (2022). https://doi.org/10.1007/s00330-022-08562-4

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  • DOI: https://doi.org/10.1007/s00330-022-08562-4

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