Peritumoral Fat Content Identified Using Iterative Decomposition of Water and Fat with Echo Asymmetry and Least-squares Estimation (IDEAL) Correlates with Breast Cancer Prognosis

  • Tani Natsumi Hirano
    Department of Radiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
  • Koreeda Yuki
    Department of Surgery 1, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
  • Nawata Aya
    Department of Pathology and Oncology, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
  • Fujisaki Akitaka
    Department of Radiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
  • Hayashida Yoshiko
    Department of Radiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
  • Shimajiri Shohei
    Department of Pathology and Cell Biology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
  • Nakayama Toshiyuki
    Department of Pathology and Cell Biology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
  • Hisaoka Masanori
    Department of Pathology and Oncology, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
  • Inoue Yuzuru
    Department of Surgery 1, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
  • Hirata Keiji
    Department of Surgery 1, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
  • Tashima Yuko
    Department of Surgery 2, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
  • Tanaka Fumihiro
    Department of Surgery 2, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
  • Aoki Takatoshi
    Department of Radiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan

抄録

<p>Purpose: Adipocytes around aggressive breast cancer (BC) are less lipid different from naive adipocytes (cancer-associated adipocytes, CAAs), and peritumoral edema caused by the release of cytokines from CAAs can conduce to decrease the peritumoral fat proportion. The purpose of this study was to correlate peritumoral fat content identified by using iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) with lymph node metastasis (LNM) and recurrence-free survival (RFS) in BC patients and to compare with T2-weighted (T2WI) and diffusion-weighted images (DWI) analyses.</p><p>Methods: This retrospective study consisted of 85 patients who were diagnosed with invasive carcinoma of breast and underwent breast MRI, including IDEAL before surgery. The scan time of fat fraction (FF) map imaging using IDEAL was 33s. Four regions of interest (ROIs), which are 5 mm from the tumor edge, and one ROI in the mammary fat of the healthy side were set on the FF map. Then average peritumoral FF values (TFF), average FF values on the healthy side (HFF), and peritumoral fat ratio (PTFR, which is defined as TFF/HFF) were calculated. Tumor apparent diffusion coefficient (ADC) values were measured on ADC map obtained by DWI. Peritumoral edema was classified into three grades based on the degree of signal intensity around the tumor on T2WI (T2 edema).</p><p>Results: The results of stepwise logistic regression analysis for four variables (TFF, PTFR, T2 edema, and ADC value) indicated that TFF and T2 edema were significant factors of LNM (p < 0.01). RFS was significantly associated with TFF (p = 0.016), and 47 of 49 (95.9%) patients with TFF more than 85.5% were alive without recurrence.</p><p>Conclusion: Peritumoral fat content identified by using IDEAL is associated with LNM and RFS and may therefore be a useful prognostic biomarker for BC.</p>

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