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Does Hypervascularity of Liver Metastases as Detected on MRI Predict Disease Progression in Breast Cancer Patients?

¹ Department of Radiology, University of North Carolina at Chapel Hill, Manning Dr., Chapel Hill, NC 27599-7510.
² Center for Excellence in Surgical Outcomes, Duke University Medical Center, Durham, NC.
³ Department of Radiology, West Virginia University, Morgantown, WV.
⁴ Present address: Department of Radiology, Emory University, 1365 Clifton Rd. NE, Bldg. A, Ste. 622, Atlanta, GA 30322.
⁵ Department of Radiology, University of Sao Paulo, Sao Paulo, Brazil.
⁶ Department of Surgery, Divisions of General Surgery and Surgical Research, University Hospital Basel, Basel, Switzerland.

OBJECTIVE. The aim of our study was to evaluate the association of the vascularity of liver metastases, as characterized by MRI, and disease progression in breast cancer patients.

MATERIALS AND METHODS. Sixteen breast cancer patients with liver metastases who underwent MRI before and after systemic therapy were retrospectively identified. On the basis of comparison of each MRI examination with the previous examination, disease status of the patients was classified as complete response, partial response, stable disease, or progressive disease. Liver metastases were characterized as hyper- or hypovascular on the basis of the degree of enhancement in the arterial, portal, and interstitial phases of imaging after administration of a contrast agent. Fisher's exact test and ordinal logistic regression models, including the type of systemic therapy, presence of multiple metastases, and hormone receptor status, were used to estimate the unadjusted and risk-adjusted association between the presence of hypervascular liver metastases and disease progression.

RESULTS. All patients in our sample (n = 16) were women and most (12/16, 75%) were white. Their median age was 51.5 years. In unadjusted analyses, the association between the presence of hypervascular liver metastases and disease progression was statistically significant (p < 0.0001). In multiple logistic regression analyses, hypervascular liver metastases were found to be an independent predictor of disease progression. Patients with hypervascular liver lesions were 20.5 times more likely to experience disease progression than patients without hypervascular metastases (odds ratio, 20.5; 95% confidence interval, 5.1–83.5; p < 0.0001).

CONCLUSION. Our analysis provides suggestive evidence that disease progression can be predicted through MRI assessment of the vascularity of liver metastases in patients with breast cancer.

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