Boetes Carla, Veltman Jeroen, van Die Lya, Bult Peter, Wobbes Theo, Barentsz Jelle O
Department of Radiology, University Medical Center Nijmegen, Nijmegen, The Netherlands.
Breast Cancer Res Treat. 2004 Jul;86(1):31-7. doi: 10.1023/B:BREA.0000032921.10481.dc.
To determine the value of MR imaging in the detection and measurement of tumor size in patients with invasive lobular carcinoma (ILC) compared to mammography and ultrasound.
From 36 cases of ILC in 34 patients who were surgically treated, the pre-operative imaging measurements, being mammography, ultrasound and contrast enhanced MR, were retrospectively re-evaluated for tumor detection and size. Findings were compared with pathology. Two radiologists were used for evaluation of the mammograms, the other imaging modalities were only evaluated by one radiologist. The Pearsons correlation test was used to determine the correlation between histopathological and imaging measurements for each imaging modality.
For mammography, ultrasound and MRI the false negative scores were respectively 14%, 3% and 0%. The percentage for underestimated, correctly estimated and overestimated measurements on imaging were 56%, 33% and 11% for radiologist 1 and 50%, 33% and 17% for radiologist 2 on mammography. For ultrasound and MRI these percentages were respectively 53%, 47%, 0% and 14%, 75%, 11%. The correlation coefficients for mammography were respectively r = 0.34 (p < 0.05) and r = 0.27 (p > 0.05) for both radiologists, for Ultrasound r = 0.24 (p > 0.05) and for MRI r = 0.81 (p < 0.01).
Of the three imaging modalities contrast enhanced MR has the lowest false negative rate in detecting ILC and has the highest accuracy in measuring the size of the ILC. MR could play a key role in the pre-operative work-up for accurate tumor size determination.
与乳腺钼靶和超声相比，确定磁共振成像（MR）在浸润性小叶癌（ILC）患者肿瘤检测及大小测量中的价值。
对34例接受手术治疗的36例ILC患者，回顾性重新评估术前影像测量结果，包括乳腺钼靶、超声及对比增强MR，以检测肿瘤并测量其大小。将结果与病理结果进行比较。两名放射科医生评估乳腺钼靶片，其他影像检查仅由一名放射科医生评估。采用Pearson相关性检验确定每种影像检查方式的组织病理学测量与影像测量之间的相关性。
对于乳腺钼靶、超声和MRI，假阴性率分别为14%、3%和0%。放射科医生1对乳腺钼靶成像低估、正确估计和高估测量的百分比分别为56%、33%和11%，放射科医生2分别为50%、33%和17%。对于超声和MRI，这些百分比分别为53%、47%、0%和14%、75%、11%。两名放射科医生对乳腺钼靶的相关系数分别为r = 0.34（p < 0.05）和r = 0.27（p > 0.05），对超声为r = 0.24（p > 0.05），对MRI为r = 0.81（p < 0.01）。
在三种成像方式中，对比增强MR在检测ILC时假阴性率最低，在测量ILC大小时准确性最高。MR在术前准确确定肿瘤大小的检查中可发挥关键作用。
