Association of T2-Weighted Imaging Features in Invasive Breast Cancer With Clinicopathologic Features and Neoadjuvant Treatment Outcomes

Sep 22, 2026

This retrospective study analyzed 179 women with invasive breast cancer who underwent preoperative 3T breast MRI between November 2020 and February 2021. Intratumoral T2 signal intensity and peritumoral edema were graded on T2-weighted imaging, and T2 relaxation times were computed with and without necrotic or cystic areas. Higher intratumoral T2 signal intensity and edema grades related to longer T2 relaxation times and multiple clinicopathologic factors. In the neoadjuvant chemotherapy subgroup, elevated intratumoral T2 signal intensity and longer relaxation times predicted disease progression, but not non-pathologic complete response.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Objective

Materials and Methods

Participants and imaging assessment

Statistical analysis

Results

Associations with T2 features and clinicopathologic factors

Associations with neoadjuvant chemotherapy outcomes

Conclusion

Original Article | Breast Imaging eISSN 2005-8330 [https://doi.org/10.3348/kjr.2025.1382](https://doi.org/10.3348/kjr.2025.1382) [Korean J Radiol 2026](Korean J Radiol 2026);[27](27)([4](4))[:305-317](:305-317) Association of T2-Weighted Imaging Features in Invasive Breast Cancer With Clinicopathologic Features and Neoadjuvant Treatment Outcomes Inyoung Youn1, Yun Ho Roh2, Min Jung Kim3,4, Jung Hyun Yoon3, Mi-ri Kwon1, Vivian Youngjean Park3 1 Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea 2 Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea 3 Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea 4 Department of Integrative Medicine Major in Digital Healthcare, Yonsei University College of Medicine, Seoul, Republic of Korea Objective: To investigate the associations between T2-weighted imaging (T2WI) features and clinicopathologic characteristics in invasive breast cancer, as well as their relationship with treatment response to neoadjuvant chemotherapy (NAC). Materials and Methods: This retrospective study included 179 women with invasive breast cancer who underwent preoperative 3T breast MRI between November 2020 and February 2021. Intratumoral T2 signal intensity (SI) and peritumoral edema were graded on T2WI, and T2 relaxation times were calculated both including and excluding necrotic or cystic areas. T2 relaxation times were compared across T2 SI grades using the Kruskal–Wallis test. Associations between T2 features and clinicopathologic factors were assessed using chi-square tests and logistic regression analyses. In patients who received NAC (n = 68), associations between T2 features and NAC outcomes were also evaluated. Results: Higher intratumoral T2 SI and peritumoral edema grades were significantly associated with longer T2 relaxation times (P < 0.001). Intratumoral T2 SI grades were associated with higher clinical T category, axillary lymph node metastasis, and tumor multiplicity (all P < 0.05) . Longer intratumoral T2 relaxation times were associated with higher clinical T category, hormone receptor (HR) negativity, and the triple-negative subtype (all P < 0.05), even after excluding necrotic or cystic areas. Higher peritumoral edema grades were associated with advanced clinical T category, HR negativity, and the triple-negative subtype (all P < 0.05) . T2 relaxation times of peritumoral edema showed no significant associations, except with higher clinical T category (P = 0.005) and estrogen receptor status (P = 0.030) . In the NAC subgroup, higher intratumoral T2 SI grades and longer T2 relaxation times were significantly associated with disease progression during NAC (P < 0.05), but not with non-pathologic complete response. Peritumoral edema showed no significant association with NAC outcomes (P > 0.05) . Conclusion: T2-weighted MRI features were associated with clinicopathologic factors, including clinical T category, HR status, triple-negative subtype, and disease progression during NAC. Keywords: Breast cancer; Magnetic resonance imaging; Neoadjuvant therapy; T2 relaxation time; T2-weighted imaging INTRODUCTION Magnetic resonance imaging (MRI) is a powerful modality for evaluating breast cancer, providing both qualitative and quantitative information [1] . While early studies primarily focused on dynamic contrast-enhanced MRI [2-4], recent research has increasingly recognized the value of noncontrast sequences [1,5-9] . Although T2-weighted imaging (T2WI) is a standard sequence in breast MRI protocols, its role beyond improving diagnostic confidence in identifying probably benign lesions has been relatively underexplored [10] . Recently, T2WI features have been reported to be Received: January 11, 2025 Revised: September 19, 2025 Accepte

FAQs

What imaging features were evaluated in this study?

The study graded intratumoral T2 signal intensity and peritumoral edema on T2-weighted imaging, and calculated T2 relaxation times with and without necrotic or cystic areas.

How were T2 imaging features related to clinicopathologic characteristics?

Higher intratumoral T2 signal intensity and peritumoral edema grades were significantly associated with longer T2 relaxation times and with factors such as clinical T category, hormone receptor status, and the triple-negative subtype.

Did the T2 features predict neoadjuvant chemotherapy outcomes?

In patients receiving neoadjuvant chemotherapy, higher intratumoral T2 signal intensity and longer T2 relaxation times were significantly associated with disease progression, while peritumoral edema showed no significant association with neoadjuvant chemotherapy outcomes.

Sep 22, 2026

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