Amide Proton Transfer-Weighted Imaging Combined with Fat Fraction Imaging for Diagnosis of Triple-Negative Breast Cancer.

[RATIONALE AND OBJECTIVES] To evaluate the diagnostic value of amide proton transfer-weighted imaging (APTw) combined with modified Dixon fat quantitation technique (mDixon-Quant) for differentiating triple-negative breast cancer (TNBC) from non-TNBC.

[MATERIALS AND METHODS] This retrospective study included 107 breast cancer patients who underwent preoperative MRI with APTw and mDixon-Quant. Based on immunohistochemistry, patients were classified into TNBC (n=24) and non-TNBC (n=83) groups. Two radiologists independently measured APTw, fat fraction (FF), and T2* values. Interobserver consistency was assessed using the intraclass correlation coefficient (ICC). Continuous and categorical variables were compared using the Mann-Whitney U and χ² tests, respectively. Diagnostic performance was evaluated and compared using receiver operating characteristic (ROC) analysis, with the DeLong test for AUC comparisons.

[RESULTS] The TNBC group showed significantly higher Ki-67 index, APTw, and T2* values, but lower FF values than the non-TNBC group (all p<0.05). The combined use of APTw and FF values demonstrated favorable diagnostic efficacy, with an AUC of 0.885. Adding Ki-67 index increased the AUC to 0.911, but the difference was not significant (p>0.05).

[CONCLUSION] APTw combined with mDixon-Quant provides valuable non-invasive imaging evidence for preoperative TNBC diagnosis, guiding clinical treatment strategies and prognostic assessment.