# Understanding cellular proliferation activity in breast cancer using multi-compartment model of transverse relaxation time mapping on 3T MRI

## TL;DR

This study explores using MRI-based transverse relaxation time models to non-invasively assess breast cancer cell proliferation, which could improve treatment monitoring.

## Contribution

The study introduces a Bayesian multi-compartment MRI model to measure intracellular transverse relaxation times linked to tumor proliferation.

## Key findings

- Single-compartment overall transverse relaxation time was significantly higher in high-proliferating tumors.
- Bayesian intra-cellular transverse relaxation time was significantly higher in high-proliferating tumors.
- Extra-cellular transverse relaxation time showed no significant difference between high and low proliferation tumors.

## Abstract

Precise understanding of proliferative activity in breast cancer holds significant value in the monitoring of neoadjuvant treatment, while current immunostaining of Ki-67 from biopsy or resected tumour suffers from partial sampling error. Multi-compartment model of transverse relaxation time has been proposed to differentiate intra- and extra-cellular space and biochemical environment but susceptible to noise, with recent development of Bayesian algorithm suggested to improve robustness. We hence hypothesise that intra- and extra-cellular transverse relaxation times using Bayesian algorithm might be sensitive to proliferative activity.

Twenty whole tumour specimens freshly excised from patients with invasive ductal carcinoma were scanned on a 3 T clinical scanner. The overall transverse relaxation time was computed using a single-compartment model with the non-linear least squares algorithm, while intra- and extra-cellular transverse relaxation times were computed using a multi-compartment model with the Bayesian algorithm. Immunostaining of Ki-67 was conducted, yielding 9 and 11 cases with high and low proliferating activities respectively.

For single-compartment model, there was a significant higher overall transverse relaxation time (p = 0.031) in high (83.55 ± 7.38 ms) against low (73.30 ± 11.30 ms) proliferating tumours. For multi-compartment model, there was a significant higher intra-cellular transverse relaxation time (p = 0.047) in high (73.52 ± 10.92 ms) against low (61.30 ± 14.01 ms) proliferating tumours. There was no significant difference in extra-cellular transverse relaxation time (p = 0.203) between high and low proliferating tumours.

Overall and Bayesian intra-cellular transverse relaxation times are associated with proliferative activities in breast tumours, potentially serving as a non-invasive imaging marker for neoadjuvant treatment monitoring.