Radiology, Vol 203, 317-321, Copyright © 1997 by Radiological Society of North America

ARTICLES

Prediction of axillary lymph node status in invasive breast cancer with dynamic contrast-enhanced MR imaging

S Mussurakis, DL Buckley and A Horsman
Centre for MR Investigations, University of Hull, Hull Royal Infirmary, England.

PURPOSE: To determine if magnetic resonance (MR) imaging can be used to predict axillary lymph node status in patients with breast cancer. MATERIALS AND METHODS: Fifty-one women with primary invasive breast cancer underwent dynamic contrast material-enhanced MR imaging of the breast Region-of-interest (ROI) analysis was performed on parametric images obtained with kinetic modeling of the data. Large and automated ROIs were selected. Typical enhancement ratios that represented the relative increase in mean pixel signal intensity were calculated for each ROI. Stepwise logistic regression analysis was applied to identify prognostic factors of axillary node status. Receiver operating characteristic analysis was performed and a Brier score and calibration curve were calculated to assess the diagnostic efficacy and predictive capability of the logistic regression model. RESULTS: The maximum enhancement ratio of the automated ROI was found to be the strongest predictor of node status (P < .001). Patient age (P = .007) and ROI size (P = .045) were also significant predictor variables. The model showed good accuracy (area beneath the fitted binormal receiver operating characteristic curve [Az] = 0.90; Brier score, 0.133). In 12 (24%) of the patients, a less than 5% or greater than 95% probability of positive-node status was correctly identified. CONCLUSION: The suggested predictive model may decrease the need for surgical staging of the axilla in patients with breast cancer.

This article has been cited by other articles:

				S. Makkat, R. Luypaert, T. Stadnik, C. Bourgain, S. Sourbron, M. Dujardin, J. De Greve, and J. De Mey Deconvolution-based Dynamic Contrast-enhanced MR Imaging of Breast Tumors: Correlation of Tumor Blood Flow with Human Epidermal Growth Factor Receptor 2 Status and Clinicopathologic Findings--Preliminary Results Radiology, November 1, 2008; 249(2): 471 - 482. [Abstract] [Full Text] [PDF]

				A. Teifke, O. Behr, M. Schmidt, A. Victor, T. W. Vomweg, M. Thelen, and H.-A. Lehr Dynamic MR Imaging of Breast Lesions: Correlation with Microvessel Distribution Pattern and Histologic Characteristics of Prognosis Radiology, May 1, 2006; 239(2): 351 - 360. [Abstract] [Full Text] [PDF]

				M. Koizumi, M. Makita, M. Yoshimoto, F. Kasumi, G. Sakamoto, and E. Ogata Indications for Sentinel Lymph Node Biopsy in Patients with Breast Cancer: Retrospective and Simulation Analyses Jpn. J. Clin. Oncol., December 1, 2002; 32(12): 517 - 524. [Abstract] [Full Text] [PDF]

				D. K. W. Yeung, W.-T. Yang, and G. M. K. Tse Breast Cancer: In Vivo Proton MR Spectroscopy in the Characterization of Histopathologic Subtypes and Preliminary Observations in Axillary Node Metastases Radiology, October 1, 2002; 225(1): 190 - 197. [Abstract] [Full Text] [PDF]

				A D Murray, R T Staff, T W Redpath, F J Gilbert, A K Ah-See, J A Brookes, I D Miller, and S Payne Dynamic contrast enhanced MRI of the axilla in women with breast cancer: comparison with pathology of excised nodes Br. J. Radiol., March 1, 2002; 75(891): 220 - 228. [Abstract] [Full Text] [PDF]

				W. T. Yang, C. Metreweli, P. K. W. Lam, and J. Chang Benign and Malignant Breast Masses and Axillary Nodes: Evaluation with Echo-enhanced Color Power Doppler US Radiology, September 1, 2001; 220(3): 795 - 802. [Abstract] [Full Text] [PDF]

				G Cserni Axillary staging of breast cancer and the sentinel node J. Clin. Pathol., October 1, 2000; 53(10): 733 - 741. [Abstract] [Full Text] [PDF]

				T. Chikui, K. Yonetsu, and T. Nakamura Multivariate Feature Analysis of Sonographic Findings of Metastatic Cervical Lymph Nodes: Contribution of Blood Flow Features Revealed by Power Doppler Sonography for Predicting Metastasis AJNR Am. J. Neuroradiol., March 1, 2000; 21(3): 561 - 567. [Abstract] [Full Text]