x
Volume 47 Issue 3
Mar.  2024
Turn off MathJax
Article Contents
Article Navigation >  Journal of Molecular Imaging  > 2024  >  47(3): 231-236
LI Rurui, ZENG Hui, FENG Jieying, LAI Wenjia, CHEN Weiguo. Value of DCE-MRI in the evaluation of preoperative core needle biopsy diagnosis of ductal carcinoma in situ and postoperative pathology upgrade to invasive ductal carcinoma[J]. Journal of Molecular Imaging, 2024, 47(3): 231-236. doi: 10.12122/j.issn.1674-4500.2024.03.02
Citation: LI Rurui, ZENG Hui, FENG Jieying, LAI Wenjia, CHEN Weiguo. Value of DCE-MRI in the evaluation of preoperative core needle biopsy diagnosis of ductal carcinoma in situ and postoperative pathology upgrade to invasive ductal carcinoma[J]. Journal of Molecular Imaging, 2024, 47(3): 231-236. doi: 10.12122/j.issn.1674-4500.2024.03.02
shu

Value of DCE-MRI in the evaluation of preoperative core needle biopsy diagnosis of ductal carcinoma in situ and postoperative pathology upgrade to invasive ductal carcinoma

doi: 10.12122/j.issn.1674-4500.2024.03.02
  • 1.

    Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China

  • 2.

    Department of Radiology, Sixth Affiliated Hospital of South China University of Technology, Foshan 528237, China

Funds:  Supported by National Natural Science Foundation of China (82171929)
  • Received Date: 2023-12-15
    Available Online: 2024-04-17
  • Publish Date: 2024-03-20
    Abstract
  •   Objective  To explore the evaluation value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in breast cancer by analyzing the MRI features of cases with ductal carcinoma in situ (DCIS) and upgraded to invasive ductal carcinoma (IDC) after surgery diagnosed by preoperative core needle biopsy (CNB).  Methods  The data of 104 patients with breast DCIS (including microinvasion) diagnosed by CNB admitted to the Sixth Affiliated Hospital of South China University of Technology from January 2012 to December 2022 were retrospectively analyzed. All patients underwent breast DCE-MRI. The DCE-MRI features of postoperative non-upgraded DCIS and postoperative upgraded IDC were compared, including size, morphology, edge, and internal enhancement pattern.  Results  Among 104 cases with DCIS by CNB before surgery, 64 remained as DCIS postoperatively (including microinvasion) and 40 were postoperatively upgraded to IDC, with an upgrading ratio (pathological underestimation) of approximately 38.5%. In the non-upgraded DCIS group, there were 18 cases of mass lesions and 46 cases of non-mass lesions; in the upgraded IDC group, there were 19 cases of mass lesions and 21 cases of non-mass lesions with statistically significant differences between the two groups (P < 0.05). In terms of DCE-MRI features, when the lesions appeared as non-mass enhancement, the non-upgraded DCIS mainly showed segmental distribution and heterogeneous enhancement, while the upgraded IDC mainly showed regional distribution and clustered enhancement. When the lesions appeared as mass enhancement, the non-upgraded DCIS group had clear margins, while the the upgraded IDC mostly had spiculated margins. Concerning the time- signal strength curve classification, the non-upgraded DCIS mainly showed plateau curves followed by persistent enhancing curves, while the the upgraded IDC mainly exhibited outflow curves followed by plateau curves, with statistically significant differences between the two groups (P < 0.05).  Conclusion  Breast DCE-MRI has potential value in determining postoperative pathological upgrade of DCIS confirmed by CNB, which is conducive to the formulation of targeted treatment plans in clinical practice.

     

    • FullText(HTML)
  • loading
    • References(26)
  • [1]
    Meurs CJC, van Rosmalen J, Menke-Pluijmers MBE, et al. A prediction model for underestimation of invasive breast cancer after a biopsy diagnosis of ductal carcinoma in situ: based on 2892 biopsies and 589 invasive cancers[J]. Br J Cancer, 2018, 119(9): 1155-62. doi: 10.1038/s41416-018-0276-6
    [2]
    Munck F, Clausen EW, Balslev E, et al. Multicentre study of the risk of invasive cancer and use of sentinel node biopsy in women with a preoperative diagnosis of ductal carcinoma in situ[J]. Br J Surg, 2019, 107(1): 96-102. doi: 10.1002/bjs.11377
    [3]
    Hortobagyi GH, Connolly JL, D'Drsi Cl, et al. The AJCC cancerstaging manual (8th ed)[M]. Springer: American College of Surgeon, 2017: 29-45.
    [4]
    曹威, 何英剑, 李金锋, 等. 超声引导下空芯针穿刺活检诊断的乳腺导管原位癌病理学低估的危险因素分析[J]. 中国癌症杂志, 2020, 30(3): 217-23. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGAZ202003009.htm
    [5]
    Hou R, Grimm LJ, Mazurowski MA, et al. Prediction of upstaging in ductal carcinoma in situ based on mammographic radiomic features[J]. Radiology, 2022, 303(1): 54-62. doi: 10.1148/radiol.210407
    [6]
    Goto M, Yuen S, Akazawa K, et al. The role of breast MR imaging in pre- operative determination of invasive disease for ductal carcinoma in situ diagnosed by needle biopsy[J]. Eur Radiol, 2012, 22(6): 1255-64. doi: 10.1007/s00330-011-2357-2
    [7]
    Greenwood HI, Wilmes LJ, Kelil T, et al. Role of breast MRI in the evaluation and detection of DCIS: opportunities and challenges[J]. Magnetic Resonance Imaging, 2020, 52(3): 697-709. doi: 10.1002/jmri.26985
    [8]
    van Bekkum S, ter Braak BPM, Plaisier PW, et al. Preoperative breast MRI in management of patients with needle biopsy-proven ductal carcinoma in situ (DCIS)[J]. Eur J Surg Oncol, 2020, 46 (10): 1854-60. doi: 10.1016/j.ejso.2020.05.028
    [9]
    Park KW, Kim SW, Han H, et al. Ductal carcinoma in situ: a risk prediction model for the underestimation of invasive breast cancer [J]. NPJ Breast Cancer, 2022, 8(1): 8. doi: 10.1038/s41523-021-00364-z
    [10]
    van Deurzen CHM, Hobbelink MGG, van Hillegersberg R, et al. Is there an indication for sentinel node biopsy in patients with ductal carcinoma in situ of the breast? A review[J]. Eur J Cancer, 2007, 43(6): 993-1001. doi: 10.1016/j.ejca.2007.01.010
    [11]
    Kanbayashi C, Iwata H. Current approach and future perspective for ductal carcinoma in situ of the breast[J]. Jpn J Clin Oncol, 2017, 47(8): 671-7. doi: 10.1093/jjco/hyx059
    [12]
    Brennan ME, Turner RM, Ciatto S, et al. Ductal carcinoma in situ at core- needle biopsy: meta- analysis of underestimation and predictors of invasive breast cancer[J]. Radiology, 2011, 260(1): 119-28. doi: 10.1148/radiol.11102368
    [13]
    Kondo T, Hayashi N, Ohde S, et al. A model to predict upstaging to invasive carcinoma in patients preoperatively diagnosed with ductal carcinoma in situ of the breast[J]. J Surg Oncol, 2015, 112 (5): 476-80. doi: 10.1002/jso.24037
    [14]
    Van Goethem M, Schelfout K, Kersschot E, et al. Comparison of MRI features of different grades of DCIS and invasive carcinoma of the breast[J]. JBR-BTR, 2005, 88(5): 225-32.
    [15]
    刘碧华, 郑晓林, 李晏, 等. 非肿块强化导管内原位癌与浸润性导管癌的MRI内部特征及分析[J]. 临床放射学杂志, 2019, 38(7): 1198-203. https://www.cnki.com.cn/Article/CJFDTOTAL-LCFS201907011.htm
    [16]
    Watanabe Y, Anan K, Saimura M, et al. Upstaging to invasive ductal carcinoma after mastectomy for ductal carcinoma in situ: predictive factors and role of sentinel lymph node biopsy[J]. Breast Cancer, 2018, 25(6): 663-70. doi: 10.1007/s12282-018-0871-7
    [17]
    Nadrljanski M, Maksimović R, Plešinac-Karapandžić V, et al. Positive enhancement integral values in dynamic contrast enhanced magnetic resonance imaging of breast carcinoma: Ductal carcinoma in situ vs. invasive ductal carcinoma[J]. Eur J Radiol, 2014, 83(8): 1363-7. doi: 10.1016/j.ejrad.2014.05.006
    [18]
    Hussein H, Chung C, Moshonov H, et al. Evaluation of apparent diffusion coefficient to predict grade, microinvasion, and invasion in ductal carcinoma in situ of the breast[J]. Acad Radiol, 2015, 22 (12): 1483-8. doi: 10.1016/j.acra.2015.08.004
    [19]
    Chan SW, Chen JH, Agrawal G, et al. Characterization of pure ductal carcinoma in situ on dynamic contrast- enhanced MR imaging: do nonhigh grade and high grade show different imaging features?[J]. J Oncol, 2010, 2010: 431341.
    [20]
    许玲辉, 彭卫军, 顾雅佳, 等. 乳腺导管原位癌的MRI表现[J]. 中华放射学杂志, 2011, 45(2): 159-63. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHGS200706023.htm
    [21]
    Shehata M, Grimm L, Ballantyne N, et al. Ductal carcinoma in situ: current concepts in biology, imaging, and treatment[J]. J Breast Imaging, 2019, 1(3): 166-76. doi: 10.1093/jbi/wbz039
    [22]
    梅昂, 华佳. 乳腺MRI对导管原位癌及其微浸润的诊断[J]. 实用放射学杂志, 2011, 27(5): 706-9. doi: 10.3969/j.issn.1002-1671.2011.05.014
    [23]
    赵雪, 朱晓龙, 赵茹. MRI对乳腺导管原位癌及浸润性导管癌的鉴别诊断价值[J]. 中国CT和MRI杂志, 2022, 20(8): 105-7. https://www.cnki.com.cn/Article/CJFDTOTAL-CTMR202208031.htm
    [24]
    Hahn SY, Han BK, Ko EY, et al. MR features to suggest microinvasive ductal carcinoma of the breast: can it be differentiated from pure DCIS?[J]. Acta Radiol, 2013, 54(7): 742-8. doi: 10.1177/0284185113484640
    [25]
    Yamada T, Mori N, Watanabe M, et al. Radiologic- pathologic correlation of ductal carcinoma in situ[J]. Radiographics, 2010, 30 (5): 1183-98. doi: 10.1148/rg.305095073
    [26]
    吴朋, 崔蕾, 郭宏兵, 等. DWI及DCE-MRI对乳腺纯导管原位癌、导管原位癌伴微浸润及浸润导管癌的鉴别诊断价值[J]. 放射学实践, 2020, 35(4): 489-96. https://www.cnki.com.cn/Article/CJFDTOTAL-FSXS202004021.htm
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(4)  / Tables(1)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (31) PDF downloads(6) Cited by()
    Proportional views
    Related
    • Copyright © 2013《Journal of Molecular Imaging》 Editorial Office ICP备00000000号
    • Key tip: Adobe Reader6 The full text may be displayed abnormally，Please upgrade to Adobe Reader7Or higher .
    • Address: 1838 North Guangzhou Dadao, Guangzhou City, Guangdong Province, China Tel: 020-61648176 E-mail: 

    Supported by: Beijing Renhe Information Technology Co. Ltd  support: info@rhhz.net

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return