Can diffusion-weighted imaging predict tumor grade and expression of Ki-67 in breast cancer? A multicenter analysis
Abstract Background Numerous studies have analyzed associations between apparent diffusion coefficient (ADC) and histopathological features such as Ki-67 proliferation index in breast cancer (BC), with mixed results. The purpose of this study was to perform a multicenter analysis to determine relati...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-06-01
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| Series: | Breast Cancer Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13058-018-0991-1 |
| _version_ | 1818870664071741440 |
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| author | Alexey Surov Paola Clauser Yun-Woo Chang Lihua Li Laura Martincich Savannah C. Partridge Jin You Kim Hans Jonas Meyer Andreas Wienke |
| author_facet | Alexey Surov Paola Clauser Yun-Woo Chang Lihua Li Laura Martincich Savannah C. Partridge Jin You Kim Hans Jonas Meyer Andreas Wienke |
| author_sort | Alexey Surov |
| collection | DOAJ |
| description | Abstract Background Numerous studies have analyzed associations between apparent diffusion coefficient (ADC) and histopathological features such as Ki-67 proliferation index in breast cancer (BC), with mixed results. The purpose of this study was to perform a multicenter analysis to determine relationships between ADC and expression of Ki-67 and tumor grade in BC. Methods For this study, data from six centers were acquired. The sample comprises 870 patients (all female; mean age, 52.6 ± 10.8 years). In every case, breast magnetic resonance imaging with diffusion-weighted imaging was performed. The comparison of ADC values in groups was performed by Mann-Whitney U test where the p values are adjusted for multiple testing (Bonferroni correction). The association between ADC and Ki-67 values was calculated by Spearman’s rank correlation coefficient. Sensitivity, specificity, negative and positive predictive values, accuracy, and AUC were calculated for the diagnostic procedures. ADC thresholds were chosen to maximize the Youden index. Results Overall, data of 870 patients were acquired for this study. The mean ADC value of the tumors was 0.98 ± 0.22 × 10− 3 mm2 s− 1. ROC analysis showed that it is impossible to differentiate high/moderate grade tumors from grade 1 lesions using ADC values. Youden index identified a threshold ADC value of 1.03 with a sensitivity of 56.2% and specificity of 67.9%. The positive predictive value was 18.2%, and the negative predictive value was 92.4%. The level of the Ki-67 proliferation index was available for 845 patients. The mean value was 12.33 ± 21.77%. ADC correlated with weak statistical significant with expression of Ki-67 (p = − 0.202, p < 0.001). ROC analysis was performed to distinguish tumors with high proliferative potential from tumors with low expression of Ki-67 using ADC values. Youden index identified a threshold ADC value of 0.91 (sensitivity 64%, specificity 50%, positive predictive value 67.7%, negative predictive value 45.0%). Conclusions ADC cannot be used as a surrogate marker for proliferation activity and/or for tumor grade in breast cancer. |
| first_indexed | 2024-12-19T12:10:37Z |
| format | Article |
| id | doaj.art-63579a838a4347489b192bc88a8c6b19 |
| institution | Directory Open Access Journal |
| issn | 1465-542X |
| language | English |
| last_indexed | 2024-12-19T12:10:37Z |
| publishDate | 2018-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Breast Cancer Research |
| spelling | doaj.art-63579a838a4347489b192bc88a8c6b192022-12-21T20:22:13ZengBMCBreast Cancer Research1465-542X2018-06-012011710.1186/s13058-018-0991-1Can diffusion-weighted imaging predict tumor grade and expression of Ki-67 in breast cancer? A multicenter analysisAlexey Surov0Paola Clauser1Yun-Woo Chang2Lihua Li3Laura Martincich4Savannah C. Partridge5Jin You Kim6Hans Jonas Meyer7Andreas Wienke8Department of Diagnostic and Interventional Radiology, University of LeipzigDepartment of Biomedical Imaging and Image-guided Therapy, Medical University of ViennaDepartment of Radiology, Soonchunhyang University HospitalInstitute of Biomedical Engineering and Instrumentation, Hangzhou Dianzi UniversityUnit of Radiology, Institute for Cancer Research and Treatment of Candiolo (IRCC)Department of Radiology, University of WashingtonDepartment of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research InstituteDepartment of Diagnostic and Interventional Radiology, University of LeipzigInstitute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-WittenbergAbstract Background Numerous studies have analyzed associations between apparent diffusion coefficient (ADC) and histopathological features such as Ki-67 proliferation index in breast cancer (BC), with mixed results. The purpose of this study was to perform a multicenter analysis to determine relationships between ADC and expression of Ki-67 and tumor grade in BC. Methods For this study, data from six centers were acquired. The sample comprises 870 patients (all female; mean age, 52.6 ± 10.8 years). In every case, breast magnetic resonance imaging with diffusion-weighted imaging was performed. The comparison of ADC values in groups was performed by Mann-Whitney U test where the p values are adjusted for multiple testing (Bonferroni correction). The association between ADC and Ki-67 values was calculated by Spearman’s rank correlation coefficient. Sensitivity, specificity, negative and positive predictive values, accuracy, and AUC were calculated for the diagnostic procedures. ADC thresholds were chosen to maximize the Youden index. Results Overall, data of 870 patients were acquired for this study. The mean ADC value of the tumors was 0.98 ± 0.22 × 10− 3 mm2 s− 1. ROC analysis showed that it is impossible to differentiate high/moderate grade tumors from grade 1 lesions using ADC values. Youden index identified a threshold ADC value of 1.03 with a sensitivity of 56.2% and specificity of 67.9%. The positive predictive value was 18.2%, and the negative predictive value was 92.4%. The level of the Ki-67 proliferation index was available for 845 patients. The mean value was 12.33 ± 21.77%. ADC correlated with weak statistical significant with expression of Ki-67 (p = − 0.202, p < 0.001). ROC analysis was performed to distinguish tumors with high proliferative potential from tumors with low expression of Ki-67 using ADC values. Youden index identified a threshold ADC value of 0.91 (sensitivity 64%, specificity 50%, positive predictive value 67.7%, negative predictive value 45.0%). Conclusions ADC cannot be used as a surrogate marker for proliferation activity and/or for tumor grade in breast cancer.http://link.springer.com/article/10.1186/s13058-018-0991-1Breast cancerADCDWIKi-67 |
| spellingShingle | Alexey Surov Paola Clauser Yun-Woo Chang Lihua Li Laura Martincich Savannah C. Partridge Jin You Kim Hans Jonas Meyer Andreas Wienke Can diffusion-weighted imaging predict tumor grade and expression of Ki-67 in breast cancer? A multicenter analysis Breast Cancer Research Breast cancer ADC DWI Ki-67 |
| title | Can diffusion-weighted imaging predict tumor grade and expression of Ki-67 in breast cancer? A multicenter analysis |
| title_full | Can diffusion-weighted imaging predict tumor grade and expression of Ki-67 in breast cancer? A multicenter analysis |
| title_fullStr | Can diffusion-weighted imaging predict tumor grade and expression of Ki-67 in breast cancer? A multicenter analysis |
| title_full_unstemmed | Can diffusion-weighted imaging predict tumor grade and expression of Ki-67 in breast cancer? A multicenter analysis |
| title_short | Can diffusion-weighted imaging predict tumor grade and expression of Ki-67 in breast cancer? A multicenter analysis |
| title_sort | can diffusion weighted imaging predict tumor grade and expression of ki 67 in breast cancer a multicenter analysis |
| topic | Breast cancer ADC DWI Ki-67 |
| url | http://link.springer.com/article/10.1186/s13058-018-0991-1 |
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