Hepatobiliary phase manifestations of breast cancer liver metastasis: differentiating molecular types through Gd-EOB-DTPA-enhanced MRI

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OBJECTIVE: The primary objective of this study is to evaluate the diagnostic efficacy of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) -enhanced magnetic resonance imaging (MRI) in distinguishing breast cancer liver metastasis (BCLM) across different molecular types. METHODS: Between August 2014 and July 2021, a cohort of 270 patients histologically diagnosed with BCLM underwent examination through dynamic contrast-enhanced MRI (DCE-MRI). The data collection encompassed clinical information of patients, as well as information on the quantity, shape, boundary, and fusion state of liver metastases. Additionally, MR sequences including T2-weighted imaging with fat suppression (FS), diffusion-weighted imaging (DWI), MR arterial phase, and hepatobiliary phase (HBP) were collected. The chi-squared test was employed to study the correlations between different molecular types of BCLM and imaging features observed in MRI. RESULTS: Significant differences were observed in the HBP image features among various subtypes of breast cancer (P = 0.022). The morphology (oval, irregular) and fusion state (converging, separated lesions) of BCLM exhibited statistically significant differences based on breast cancer subtypes (P = 0.022, 0.004). No statistical differences were found in the quantity of BCLM, the boundary of metastasis (clear or vague), and imaging features of the T2WI-FS and DWI concerning the molecular subtypes of BCLM (P = 0.693, 0.161, 0.629, 0.629). CONCLUSION: The findings suggest that MRI, particularly Gd-EOB-DTPA-enhanced MRI, they displayed varied enhancement patterns, including the low signal, "target sign", "rim enhancement", and "doughnut-like enhancement". Most basal-like metastases demonstrated a low signal, the other molecular types primarily showing the "target sign". This is invaluable in the imaging diagnosis of BCLM across different molecular type. CLINICAL TRIAL NUMBER: Not applicable.

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