Title:Assessment of Apparent Diffusion Coefficient Parameters and Coefficient of
Variance in Discrimination of Receptor Status and Molecular Subtypes of
Breast Cancer
Volume: 20
Author(s): Ozlem Ozkul, Ibrahim Sever and Bahattin Ozkul*
Affiliation:
- Department of Radiology, Istanbul Atlas University, Medicine Hospital, Hamidiye mah. Anadolu cad. No:40 Kagithane/Istanbul, Turkey
Keywords:
ADC, ADCcV, Breast cancer, DW-MRI, Molecular subtype, Immunohistochemistry
Abstract:
Objective:
The objective of this study was to investigate the diagnostic power of apparent diffusion coefficient/coefficient of variance (ADCcV) as well as
ADC parameters formed based on magnetic resonance images (MRI) in the distinction of molecular breast cancer subtypes.
Methods:
The study involved 205 patients who had breast cancer at stages 1-3. Estrogen receptor (EsR), progesterone receptor (PrR), human epidermal
growth factor receptor 2 (Her2), and proliferation index (Ki-67) were histologically analyzed in the tumor. The correlations between the
immunohistochemistry and intrinsic subtypes were analyzed using ADC and ADCcV.
Results:
The maximum whole tumor (WTu) ADC (p=0.004), minimum WTu ADC (p<0.001), and mean WTu ADC (p<0.001) values were significantly
smaller in the EsR-positive tumors than those in the EsR-negative tumors. Compared to the PrR-negative tumors, the PrR-positive tumors showed
significantly smaller maximum, minimum, and mean WTu ADC values (p=0.005, p=0.001, and p<0.001, respectively). In the comparisons of the
molecular subtypes in terms of ADCcV, the p-values indicated statistically significant differences between the luminal A (lumA) group and the
triple negative (TN) group, between the luminal B (lumB) group and the TN group, and between the Her2-enriched and TN groups (p<0.001,
p=0.011, and p=0.004, respectively). Considering the luminal and non-luminal groups, while a significant difference was observed between the
groups considering their minimum, maximum, and mean WTu ADC values, their ADCcV values were similar (p<0.001, p=0.004, and p<0.001,
respectively).
Conclusion:
Using ADCcV in addition to ADC parameters increased the diagnostic power of diffusion weighted-MRI (DW-MRI) in the distinction of
molecular subtypes of breast cancer.
