Quantitative Parameters of Intravoxel Incoherent Movement Imaging and Dynamic Contrast Enhancement MRI for the Prediction of HER2-Zero, -Low, and -Positive Breast Cancers

Siqi Zhao; Shiyu Wang; Yuanfei Li; Yueqi Wu; Moyun Zhang; Ning Ning; Hongbing Liang; Deshuo Dong; Jie Yang; Xue Gao; Haonan Guan; Lina Zhang

doi:10.1016/j.acra.2024.11.011

Quantitative Parameters of Intravoxel Incoherent Movement Imaging and Dynamic Contrast Enhancement MRI for the Prediction of HER2-Zero, -Low, and -Positive Breast Cancers

Acad Radiol. 2024 Nov 25:S1076-6332(24)00857-2. doi: 10.1016/j.acra.2024.11.011. Online ahead of print.

Authors

Siqi Zhao¹, Shiyu Wang², Yuanfei Li³, Yueqi Wu⁴, Moyun Zhang⁵, Ning Ning⁶, Hongbing Liang⁷, Deshuo Dong⁸, Jie Yang⁹, Xue Gao¹⁰, Haonan Guan¹¹, Lina Zhang¹²

Affiliations

¹ Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China (S.Z., S.W., Y.L., Y.W., M.Z., H.L., D.D., L.Z.). Electronic address: zhaosiqifighting@163.com.
² Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China (S.Z., S.W., Y.L., Y.W., M.Z., H.L., D.D., L.Z.). Electronic address: wangshiyu067@163.com.
³ Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China (S.Z., S.W., Y.L., Y.W., M.Z., H.L., D.D., L.Z.). Electronic address: lyfyuan18@163.com.
⁴ Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China (S.Z., S.W., Y.L., Y.W., M.Z., H.L., D.D., L.Z.). Electronic address: 3359237860@qq.com.
⁵ Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China (S.Z., S.W., Y.L., Y.W., M.Z., H.L., D.D., L.Z.). Electronic address: 18630627036@163.com.
⁶ Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, No. 6 Jiefang Street, Zhongshan District, Dalian, Liaoning 116001, PR China (N.N.). Electronic address: 975386640@qq.com.
⁷ Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China (S.Z., S.W., Y.L., Y.W., M.Z., H.L., D.D., L.Z.). Electronic address: 1379759387@qq.com.
⁸ Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China (S.Z., S.W., Y.L., Y.W., M.Z., H.L., D.D., L.Z.). Electronic address: 2231371623@qq.com.
⁹ School of Public Health, Dalian Medical University, No. 9W. Lvshun South Road, Dalian, Liaoning Province 116044, PR China (J.Y.). Electronic address: yjie521@163.com.
¹⁰ Department of Pathology, First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Dalian, Liaoning 116011, PR China (X.G.). Electronic address: xueer_128@163.com.
¹¹ GE Healthcare, MR Research China, Beijing 100176, PR China (H.G.). Electronic address: Haonan.Guan@gehealthcare.com.
¹² Department of Radiology, First Affiliated Hospital of Dalian Medical University, No 222 zhongshan Road, Xigang district, Dalian, Liaoning 116011, PR China (S.Z., S.W., Y.L., Y.W., M.Z., H.L., D.D., L.Z.). Electronic address: zln201045@163.com.

PMID: 39592385
DOI: 10.1016/j.acra.2024.11.011

Abstract

Rationale and objectives: To explore the predictive value of quantitative parameters from intravoxel incoherent movement (IVIM) imging and dynamic contrast enhancement MRI (DCE-MRI) for HER2 expression in breast cancer.

Materials and methods: This retrospective study included 167 women with breast cancer who underwent MRI from December 2019 to December 2023, categorized into 48 HER2-positive, 78 HER2-low and 41 HER2-zero cancers. All patients underwent IVIM imaging and DCE-MRI. Statistical analyses, including one-way ANOVA, Kruskal-Wallis test and χ2 test, were employed to compare clinical data, MRI features, and MRI quantitative parameters including standard ADC(ADC), pure diffusion coefficient(D), perfusion-related diffusion coefficient(D*), perfusion fraction(f), volume transfer constant(K^trans), extravascular extracellular interstitial volume ratio(V_e) and rate constant(K_ep) between the three groups. Multivariable logistic regression was used to identify independent predictors for distinguishing HER2 expressions. The diagnostic efficacy of significant IVIM and DCE parameters for different HER2 expressions was analyzed using receiver operator characteristic (ROC) curves.

Results: Peritumoral edema, histological grade and K_ep achieved an AUC of 0.86(95%CI:0.78,0.91) in distinguishing HER2-positive tumors from HER2-low expressing tumors and were independent predictors for differentiating these two groups. Among HER2-positive and -zero breast cancers, the combined model of D*, K^trans and K_ep had an AUC of 0.74(95%CI:0.63,0.82) for the prediction of HER2-positive versus HER2-zero cancers, and its prediction efficiency was not improved compared with that of a single parameter(P > .05).

Conclusion: Quantitative parameters from intravoxel incoherent movement imaging and dynamic contrast enhancement MRI can predict different HER2 expressions in breast cancer from different perspectives, with implications for therapy.

Keywords: Brest cancer; Dynamic contrast-enhanced MRI; Human epidermal growth factor receptor 2; Intravoxel Incoherent Movement Imging; Magnetic resonance imaging.