Correlation of CT-data derived from multiparametric dual-layer CT-maps with immunohistochemical biomarkers in invasive breast carcinomas

Kathrin Barbara Krug; Birgid Schömig-Markiefka; Graeme M Campbell; Michael Püsken; David Maintz; Marc Schlamann; Konstantin Klein; Darius Gabriel Schafigh; Wolfram Malter; Martin Hellmich

doi:10.1016/j.ejrad.2022.110544

Correlation of CT-data derived from multiparametric dual-layer CT-maps with immunohistochemical biomarkers in invasive breast carcinomas

Eur J Radiol. 2022 Nov:156:110544. doi: 10.1016/j.ejrad.2022.110544. Epub 2022 Sep 24.

Affiliations

¹ Department of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany. Electronic address: Barbara.krug@uk-koeln.de.
² Department of Pathology, University Hospital of Cologne, Cologne, Germany.
³ Philips GmbH Market DACH, Hamburg, Germany.
⁴ Department of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany.
⁵ Department of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany; Ear, Nose and Throat Clinic, University Hospital of Cologne, Cologne, Germany.
⁶ Breast Cancer Center, Department of Gynecology and Obstetrics, University of Cologne, Cologne, Germany.
⁷ Institute of Medical Statistics and Bioinformatics, Medical Faculty, University of Cologne, Germany.

PMID: 36219916
DOI: 10.1016/j.ejrad.2022.110544

Abstract

Objective: To examine the correlation of quantitative measurements from material decomposition maps calculated from dual-layer CT (DLCT)-image datasets with immunohistochemical biomarkers of invasive breast carcinomas.

Material and methods: All patients at the University Breast Cancer Center who underwent a clinically indicated dual-layer CT-scan for staging of invasive ductal breast carcinoma from 01/2016 to 07/2020 were prospectively included. Iodine concentration maps and maps of the effective atomic numbers (Zeffective) were reconstructed from the image datasets. ROI-based evaluations of the index tumors and predefined references tissues for normalization were performed semi-automatically in identical anatomical positions using dedicated evaluation software. Statistical analysis was essentially descriptive using Spearmańs rank correlation and (multivariable) partial correlation.

Results: Bivariate showed statistically significant correlations of iodine contents (r = -0.154/-0.202/0.180, p = 0.039/0.006/0.015), and Zeffective-values (r = -0.158/-0.199/0.179, p = 0.034/0.007/0.016) for all 184 carcinomas and the subgroup of 168 invasive ductal carcinomas. The results were confirmed by multivariate analyses with "age", "diameter" and "ACR-grade" as possible confounders. Normalization of the measured target values with those in the aorta confirmed significant correlations of iodine content and Zeffective compared to Estrogen (r = 0.174, p = 0.019), Progesteron (r = 0.168/0.177, p = 0.024/0.017), and HER2 receptor expression (r = -0.222/-0.184, p = 0.003/0.013). All CT-parameters showed significant correlations with immunohistochemical subtyping (r = 0.191/0.192, p = 0.010).

Conclusions: Our preliminary results indicate that iodine content and Zeffective-values derived from DLCT-examinations correlate with hormone receptor expression in invasive breast carcinomas. Assignments to benign entities already seam feasible in clinical routine CT-diagnostics. After further investigations iodine content and Zeffective may be translated as diagnostical and prognostical biomarkers into clinical routine in the long term.

Keywords: Chest CT; Dual-energy computed tomography (CT), biomarkers in breast cancer; Quantitative CT-texture analysis; Spectral computed tomography (CT).