Differentiation of histological calcification classifications in breast cancer using ultrashort echo time and chemical shift-encoded imaging MRI

Yazan Khaled Jamal Ayoub; Sai Man Cheung; Boddor Maglan; Nicholas Senn; Kwok-Shing Chan; Jiabao He

doi:10.3389/fonc.2024.1475090

Differentiation of histological calcification classifications in breast cancer using ultrashort echo time and chemical shift-encoded imaging MRI

Yazan Khaled Jamal Ayoub
, Sai Man Cheung
, Boddor Maglan
, Nicholas Senn
, Kwok-Shing Chan
, Jiabao He^* (Corresponding Author)

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

Introduction: Ductal carcinoma in situ (DCIS) accounts for 25% of newly diagnosed breast cancer cases with only 14%–53% developing into invasive ductal carcinoma (IDC), but currently overtreated due to inadequate accuracy of mammography. Subtypes of calcification, discernible from histology, has been suggested to have prognostic value in DCIS, while the lipid composition of saturated and unsaturated fatty acids may be altered in de novo synthesis with potential sensitivity to the difference between DCIS and IDC. We therefore set out to examine calcification using ultra short echo time (UTE) MRI and lipid composition using chemical shift-encoded imaging (CSEI), as markers for histological calcification classification, in the initial ex vivo step towards in vivo application.

Methods: Twenty female patients, with mean age (range) of 57 (35–78) years, participated in the study. Intra- and peri-tumoural degree of calcification and peri-tumoural lipid composition were acquired on MRI using UTE and CSEI, respectively. Ex vivo imaging was conducted on the freshly excised breast tumour specimens immediately after surgery. Histopathological analysis was conducted to determine the calcification status, Nottingham Prognostic Index (NPI), and proliferative activity marker Ki-67.

Results: Intra-tumoural degree of calcification in malignant classification (1.05 ± 0.13) was significantly higher (p = 0.012) against no calcification classification (0.84 ± 0.09). Peri-tumoural degree of calcification in malignant classification (1.64 ± 0.10) was significantly higher (p = 0.033) against no calcification classification (1.41 ± 0.18). Peri-tumoural MUFA in malignant classification (0.40 ± 0.01) was significantly higher (p = 0.039) against no calcification classification (0.38 ± 0.02). Ki-67 showed significant negative correlation against peri-tumoural MUFA (p = 0.043, ρ = −0.457), significant positive correlation against SFA (p = 0.008, ρ = 0.577), and significant negative correlation against PUFA (p = 0.002, ρ = −0.653).

Conclusion: The intra- and peri-tumoural degree of calcification and peri-tumoural MUFA are sensitive to histological calcification classes supporting future investigation into DCIS prognosis.

Original language	English
Article number	1475090
Number of pages	13
Journal	Frontiers in Oncology
Volume	14
Early online date	17 Dec 2024
DOIs	https://doi.org/10.3389/fonc.2024.1475090
Publication status	Published - 2024

Data Availability Statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

The Supplementary Material for this article can be found online
at: https://www.frontiersin.org/articles/10.3389/fonc.2024.1475090/
full#supplementary-material

Funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This project was funded by NHS Grampian Endowment Research Fund (15/1/052). YA’s PhD study is supported by Elphinstone scholarship. NS’s PhD study was supported by BBSRC EASTBIO scholarship (1654748, BB/M010996/1). SMC was funded by Cancer Research UK (C68628/A28312). The funding sources were not involved in the study design, collection, analysis, and interpretation of data, in the writing of the report, nor in the decision to submit the article for publication.

Funders	Funder number
NHS Grampian Endowment	15/1/052
Elphinstone PhD Scholarship
Biotechnology and Biological Sciences Research Council	BB/M010996/1, 1654748
Cancer Research UK	C68628/A28312

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

invasive ductal carcinoma
ductal carcinoma in situ
ultrashort echo time
lipid composition
chemical shift-encoded imaging

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@article{df4ea645c3b144fe911ae80260812fa5,

title = "Differentiation of histological calcification classifications in breast cancer using ultrashort echo time and chemical shift-encoded imaging MRI",

abstract = "Introduction: Ductal carcinoma in situ (DCIS) accounts for 25\% of newly diagnosed breast cancer cases with only 14\%–53\% developing into invasive ductal carcinoma (IDC), but currently overtreated due to inadequate accuracy of mammography. Subtypes of calcification, discernible from histology, has been suggested to have prognostic value in DCIS, while the lipid composition of saturated and unsaturated fatty acids may be altered in de novo synthesis with potential sensitivity to the difference between DCIS and IDC. We therefore set out to examine calcification using ultra short echo time (UTE) MRI and lipid composition using chemical shift-encoded imaging (CSEI), as markers for histological calcification classification, in the initial ex vivo step towards in vivo application. Methods: Twenty female patients, with mean age (range) of 57 (35–78) years, participated in the study. Intra- and peri-tumoural degree of calcification and peri-tumoural lipid composition were acquired on MRI using UTE and CSEI, respectively. Ex vivo imaging was conducted on the freshly excised breast tumour specimens immediately after surgery. Histopathological analysis was conducted to determine the calcification status, Nottingham Prognostic Index (NPI), and proliferative activity marker Ki-67. Results: Intra-tumoural degree of calcification in malignant classification (1.05 ± 0.13) was significantly higher (p = 0.012) against no calcification classification (0.84 ± 0.09). Peri-tumoural degree of calcification in malignant classification (1.64 ± 0.10) was significantly higher (p = 0.033) against no calcification classification (1.41 ± 0.18). Peri-tumoural MUFA in malignant classification (0.40 ± 0.01) was significantly higher (p = 0.039) against no calcification classification (0.38 ± 0.02). Ki-67 showed significant negative correlation against peri-tumoural MUFA (p = 0.043, ρ = −0.457), significant positive correlation against SFA (p = 0.008, ρ = 0.577), and significant negative correlation against PUFA (p = 0.002, ρ = −0.653). Conclusion: The intra- and peri-tumoural degree of calcification and peri-tumoural MUFA are sensitive to histological calcification classes supporting future investigation into DCIS prognosis.",

keywords = "invasive ductal carcinoma, ductal carcinoma in situ, ultrashort echo time, lipid composition, chemical shift-encoded imaging",

author = "Ayoub, \{Yazan Khaled Jamal\} and Cheung, \{Sai Man\} and Boddor Maglan and Nicholas Senn and Kwok-Shing Chan and Jiabao He",

year = "2024",

doi = "10.3389/fonc.2024.1475090",

language = "English",

volume = "14",

journal = "Frontiers in Oncology",

issn = "2234-943X",

publisher = "Frontiers Media S.A.",

}

TY - JOUR

T1 - Differentiation of histological calcification classifications in breast cancer using ultrashort echo time and chemical shift-encoded imaging MRI

AU - Ayoub, Yazan Khaled Jamal

AU - Cheung, Sai Man

AU - Maglan, Boddor

AU - Senn, Nicholas

AU - Chan, Kwok-Shing

AU - He, Jiabao

PY - 2024

Y1 - 2024

N2 - Introduction: Ductal carcinoma in situ (DCIS) accounts for 25% of newly diagnosed breast cancer cases with only 14%–53% developing into invasive ductal carcinoma (IDC), but currently overtreated due to inadequate accuracy of mammography. Subtypes of calcification, discernible from histology, has been suggested to have prognostic value in DCIS, while the lipid composition of saturated and unsaturated fatty acids may be altered in de novo synthesis with potential sensitivity to the difference between DCIS and IDC. We therefore set out to examine calcification using ultra short echo time (UTE) MRI and lipid composition using chemical shift-encoded imaging (CSEI), as markers for histological calcification classification, in the initial ex vivo step towards in vivo application. Methods: Twenty female patients, with mean age (range) of 57 (35–78) years, participated in the study. Intra- and peri-tumoural degree of calcification and peri-tumoural lipid composition were acquired on MRI using UTE and CSEI, respectively. Ex vivo imaging was conducted on the freshly excised breast tumour specimens immediately after surgery. Histopathological analysis was conducted to determine the calcification status, Nottingham Prognostic Index (NPI), and proliferative activity marker Ki-67. Results: Intra-tumoural degree of calcification in malignant classification (1.05 ± 0.13) was significantly higher (p = 0.012) against no calcification classification (0.84 ± 0.09). Peri-tumoural degree of calcification in malignant classification (1.64 ± 0.10) was significantly higher (p = 0.033) against no calcification classification (1.41 ± 0.18). Peri-tumoural MUFA in malignant classification (0.40 ± 0.01) was significantly higher (p = 0.039) against no calcification classification (0.38 ± 0.02). Ki-67 showed significant negative correlation against peri-tumoural MUFA (p = 0.043, ρ = −0.457), significant positive correlation against SFA (p = 0.008, ρ = 0.577), and significant negative correlation against PUFA (p = 0.002, ρ = −0.653). Conclusion: The intra- and peri-tumoural degree of calcification and peri-tumoural MUFA are sensitive to histological calcification classes supporting future investigation into DCIS prognosis.

AB - Introduction: Ductal carcinoma in situ (DCIS) accounts for 25% of newly diagnosed breast cancer cases with only 14%–53% developing into invasive ductal carcinoma (IDC), but currently overtreated due to inadequate accuracy of mammography. Subtypes of calcification, discernible from histology, has been suggested to have prognostic value in DCIS, while the lipid composition of saturated and unsaturated fatty acids may be altered in de novo synthesis with potential sensitivity to the difference between DCIS and IDC. We therefore set out to examine calcification using ultra short echo time (UTE) MRI and lipid composition using chemical shift-encoded imaging (CSEI), as markers for histological calcification classification, in the initial ex vivo step towards in vivo application. Methods: Twenty female patients, with mean age (range) of 57 (35–78) years, participated in the study. Intra- and peri-tumoural degree of calcification and peri-tumoural lipid composition were acquired on MRI using UTE and CSEI, respectively. Ex vivo imaging was conducted on the freshly excised breast tumour specimens immediately after surgery. Histopathological analysis was conducted to determine the calcification status, Nottingham Prognostic Index (NPI), and proliferative activity marker Ki-67. Results: Intra-tumoural degree of calcification in malignant classification (1.05 ± 0.13) was significantly higher (p = 0.012) against no calcification classification (0.84 ± 0.09). Peri-tumoural degree of calcification in malignant classification (1.64 ± 0.10) was significantly higher (p = 0.033) against no calcification classification (1.41 ± 0.18). Peri-tumoural MUFA in malignant classification (0.40 ± 0.01) was significantly higher (p = 0.039) against no calcification classification (0.38 ± 0.02). Ki-67 showed significant negative correlation against peri-tumoural MUFA (p = 0.043, ρ = −0.457), significant positive correlation against SFA (p = 0.008, ρ = 0.577), and significant negative correlation against PUFA (p = 0.002, ρ = −0.653). Conclusion: The intra- and peri-tumoural degree of calcification and peri-tumoural MUFA are sensitive to histological calcification classes supporting future investigation into DCIS prognosis.

KW - invasive ductal carcinoma

KW - ductal carcinoma in situ

KW - ultrashort echo time

KW - lipid composition

KW - chemical shift-encoded imaging

U2 - 10.3389/fonc.2024.1475090

DO - 10.3389/fonc.2024.1475090

M3 - Article

SN - 2234-943X

VL - 14

JO - Frontiers in Oncology

JF - Frontiers in Oncology

M1 - 1475090

ER -

Differentiation of histological calcification classifications in breast cancer using ultrashort echo time and chemical shift-encoded imaging MRI

Abstract

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UN SDGs

Keywords

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