Time-to-enhancement at ultrafast breast DCE-MRI: potential imaging biomarker of tumour aggressiveness

Research output: Contribution to journalArticle


Objectives: This study was conducted in order to investigate whether there is a correlation between the time-to-enhancement (TTE) in ultrafast MRI and histopathological characteristics of breast cancers. Methods: Between January and August 2017, 274 consecutive breast cancer patients (mean age, 53.5 years; range, 25–80 years) who underwent ultrafast MRI and subsequent surgery were included for analysis. Ultrafast MRI scans were acquired using TWIST-VIBE or 4D TRAK-3D TFE sequences. TTE and maximum slope (MS) were derived from the ultrafast MRI. The repeated measures ANOVA, Mann–Whitney U test and Kruskal–Wallis H test were performed to compare the median TTE, MS and SER according to histologic type, histologic grade, ER/PR/HER2 positivity, level of Ki-67 and tumour subtype. For TTE calculation, intraclass correlation coefficient (ICC) was used to evaluate interobserver variability. Results: The median TTE of invasive cancers was shorter than that of in situ cancers (p < 0.001). In invasive cancers, large tumours showed shorter TTE than small tumours (p = 0.001). High histologic/nuclear grade cancers had shorter TTE than low to intermediate grade cancers (p < 0.001 and p < 0.001). HER2-positive cancers showed shorter TTE than HER2-negative cancers (p = 0.001). The median TTE of cancers with high Ki-67 was shorter than that of cancers with low Ki-67 (p < 0.001). ICC between two readers showed moderate agreement (0.516). No difference was found in the median MS or SER values according to the clinicopathologic features. Conclusions: The median TTE of breast cancer in ultrafast MRI was shorter in invasive or aggressive tumours than in in situ cancer or less aggressive tumours, respectively. Key Points: • Invasive breast tumours show a shorter TTE in ultrafast DCE-MRI than in situ cancers. • A shorter TTE in ultrafast DCE-MRI is associated with breast tumours of a large size, high histologic or nuclear grade, PR negativity, HER2 positivity and high Ki-67 level.

Original languageEnglish
Pages (from-to)4058-4068
Number of pages11
JournalEuropean Radiology
Issue number7
StatePublished - 2020


  • Breast
  • Magnetic resonance imaging
  • Neoplasms

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