Peritumoral fat content using iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) is associated with triple-negative breast cancer.

Authors

Yuki Koreeda, Akitaka Fujisaki, Yojiro Tsuda, Natsumi Tani, Takayuki Tanoue, Yuko Tashima, Shohei Shimajiri, Yoshiko Hayashida, Mariko Yamaguchi, Yuzuru Inoue, Keiji Hirata, Takatoshi Aoki

Published in

Japanese journal of radiology. Jul 22, 2026. Epub Jul 22, 2026.

Abstract

The purpose of this study was to elucidate the association triple-negative breast cancer (TNBC) with peritumoral fat content identified by using iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL), and to compare IDEAL-based fat measurements with findings obtained from T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced MRI (DCE-MRI).
We analyzed 538 consecutive patients diagnosed with breast cancer who underwent IDEAL MRI prior to surgery or biopsy. After applying the exclusion criteria, 265 patients with 270 lesions were included in this study. Using a 3 T MRI system, we created fat fraction maps and measured the average peritumoral fat fraction value (TFF) in 4 regions of interest (ROIs) surrounding the tumor. We also calculated the fat fraction ratio (pTFR: TFF/HFF) by measuring fat fraction in the contralateral healthy side breast (HFF). Additionally, we assessed apparent diffusion coefficient (ADC) values from DWI, classified peritumoral edema based on T2WI-based grading system and evaluated the presence of rim enhancement on the early phase DCE-MRI images.
The TNBC and non-TNBC groups consisted of 38 and 232 lesions, respectively. The TNBC group exhibited significantly lower TFF and pTFR values compared with the non-TNBC group (p < 0.001). A significant association was observed with T2 edema (p = 0.028), whereas no significant difference was found in ADC values (p = 0.946). Among the significantly contributing quantitative parameters (p < 0.05), pTFR demonstrated the highest diagnostic performance (AUC = 0.749, 95% CI: 0.664 to 0.834). A prediction model based on pTFR and rim enhancement on the early phase of DCE-MRI achieved an AUC of 0.777 (95% CI: 0.703 to 0.850).
Peritumoral fat content measured using IDEAL was lower in the TNBC group than in the non-TNBC group, and may be useful for predicting TNBC.

PMID:
42484835
Bibliographic data and abstract were imported from PubMed on 22 Jul 2026.

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