Improved discrimination of molecular subtypes in invasive breast cancer: Comparison of multiple quantitative parameters from breast MRI

Abstract Purpose To compare multiple quantitative parameters from breast magnetic resonance imaging (MRI) with the synthetic MRI sequence included for discrimination of molecular subtypes of invasive breast cancer. Materials and methods Between March 2019 and September 2020, two hundred breast cancer patients underwent preoperative breast multiparametric MRI examinations including synthetic MRI, diffusion weighted imaging (DWI) and dynamic contrast enhancement (DCE)-MRI sequences. MRI morphological features, T1 and T2 relaxation times (T1, T2) and proton density (PD) values from synthetic MRI, Ktrans, Kep, and Ve from DCE-MRI, mean apparent diffusion coefficient (ADC) from DWI and tumor volume were measured. Quantitative parameters were compared according to molecular markers and subtypes. Logistic regression were performed to find the related MRI parameters and establish combined parameters. The comparison between single and combined quantitative parameters by using DeLong tests. Results T1, T2 values were significantly higher in hormone receptor (HR)- negative and Ki67 > 14% tumors (p   14% tumors (p   14% tumors (p  Conclusions MRI quantitative parameters could help distinguish molecular markers and subtypes. The emerging synthetic MRI parameters - T1 values were associated with the TN subtype, and combined parameters with added T2 values might improve the discrimination of the luminal A subtype. Application of synthetic MRI can enrich quantitative descriptors from breast MRI.