Associations Between Tumor Vascularization Assessed by In Vivo DCE-MRI and the Presence of Disseminated Tumor Cells in Bone Marrow in Breast Cancer Patients at the Time of Diagnosis

PurposeTo explore possible associations between in vivo pharmacokinetic dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters and the presence of disseminated tumor cells (DTCs) in bone marrow in breast cancer patients at the time of diagnosis. Materials and MethodsThirty-seven women with breast cancer (stage T2-4N0-1M0) were included. Patients were classified as DTC+ if one or more DTCs were detected by immunocytochemistry. DCE-MRI was acquired with a radial 3D T-1-weighted spoiled gradient echo sequence with k-space weighted image contrast. K-trans, k(ep), and v(e) were calculated using the extended Tofts model and a population-derived arterial input function. The nonparametric Mann-Whitney U-test was used to compare the histogram distributions of the pharmacokinetic parameters for the DTC+ and the DTC- patients. ResultsDTCs were detected in 7 of the 37 patients (19%). In DTC+ patients, the distribution of tumor K-trans and k(ep) were significantly (P < 0.01) more shifted towards lower values than in DTC- patients. ConclusionAn association between vascular dependent pharmacokinetic DCE-MRI parameters and the presence of DTCs were found. Compared to DTC- patients, DTC+ patients had poorer perfusion and permeability, indicative of hypoxia. Thus, pharmacokinetic parameters might be surrogate biomarkers of metastatic potential and future relapse.J. Magn. Reson. Imaging 2014;40:1382-1391. (c) 2014 Wiley Periodicals, Inc.