Dynamic Contrast-Enhanced MRI Perfusion Parameters as Imaging Biomarkers of Angiogenesis

TLDR

Hypoxia drives tumor angiogenesis, which can be detected by dynamic contrast‑enhanced breast MRI. The study examines how DCE MRI perfusion metrics relate to angiogenic and prognostic markers in invasive ductal carcinoma. Eighty‑one IDC lesions were evaluated by histogram analysis of Ktrans, kep, and ve, with 25th, 50th, and 75th percentiles correlated to microvessel density, VEGF, and standard prognostic factors. Ktrans50 correlated positively with tumor size and MVD, explaining 12.8 % of variance, while ve50 showed a modest positive correlation with MVD (r = 0.33), indicating that DCE MRI perfusion metrics can serve as imaging biomarkers of angiogenesis and tumor aggressiveness.

Abstract

Hypoxia in the tumor microenvironment is the leading factor in angiogenesis. Angiogenesis can be identified by dynamic contrast-enhanced breast MRI (DCE MRI). Here we investigate the relationship between perfusion parameters on DCE MRI and angiogenic and prognostic factors in patients with invasive ductal carcinoma (IDC). Perfusion parameters (Ktrans, kep and ve) of 81 IDC were obtained using histogram analysis. Twenty-fifth, 50th and 75th percentile values were calculated and were analyzed for association with microvessel density (MVD), vascular endothelial growth factor (VEGF) and conventional prognostic factors. Correlation between MVD and ve50 was positive (r = 0.33). Ktrans50 was higher in tumors larger than 2 cm than in tumors smaller than 2 cm. In multivariate analysis, Ktrans50 was affected by tumor size and MVD with 12.8% explanation. There was significant association between Ktrans50 and tumor size and MVD. Therefore we conclude that DCE MRI perfusion parameters are potential imaging biomarkers for prediction of tumor angiogenesis and aggressiveness.