早期浸润性乳腺癌：光学断层成像与超声定位辅助诊断的潜在作用。
Early-stage invasive breast cancers: potential role of optical tomography with US localization in assisting diagnosis.
机构信息
Bioengineering Program, University of Connecticut, 371 Fairfield Rd, U2157, Storrs, CT 06269, USA.
出版信息
Radiology. 2010 Aug;256(2):367-78. doi: 10.1148/radiol.10091237. Epub 2010 Jun 22.
PURPOSE
To investigate the potential role of optical tomography in the near-infrared (NIR) spectrum with ultrasonographic (US) localization as a means of differentiating early-stage cancers from benign lesions of the breast.
MATERIALS AND METHODS
The protocol was approved by the institutional review boards and was HIPAA compliant; all participants signed an informed consent. One hundred seventy-eight consecutive women (mean age, 52 years; range, 21-89 years) who underwent US-guided biopsy were imaged with a hand-held probe consisting of a coregistered US transducer and an NIR imager. The lesion location provided by coregistered US was used to guide optical imaging. Light absorption was measured at two optical wavelengths. From this measurement, tumor angiogenesis was assessed on the basis of calculated total hemoglobin concentration (tHb) and was correlated with core biopsy results. For patients diagnosed with carcinomas and followed up with subsequent excision, the tHb was correlated with pathologic parameters.
RESULTS
There were two in situ carcinomas (Tis), 35 T1 carcinomas, 24 T2-T4 carcinomas, and 114 benign lesions. The mean maximum and mean average tHb of the Tis-T1 group were 102.0 micromol/L +/- 28.5 (standard deviation) and 71.9 micromol/L +/- 18.8, and those of the T2-T4 group were 100.3 micromol/L +/- 26.4 and 67.0 micromol/L +/- 18.3, respectively. The mean maximum and mean average tHb of the benign group were 55.1 micromol/L +/- 22.7 and 39.1 micromol/L +/- 14.9, respectively. Both mean maximum and mean average tHb levels were significantly higher in the malignant groups than they were in the benign group (P < .001). The sensitivity, specificity, positive predictive value, and negative predictive value for Tis-T1 cancers were 92%, 93%, 81%, and 97%. The corresponding values for T2-T4 tumors were 75%, 93%, 69%, and 95%.
CONCLUSION
The angiogenesis (tHb) contrast imaged by using the NIR technique with US holds promise as an adjunct to mammography and US for distinguishing early-stage invasive breast cancers from benign lesions.
目的
利用超声（US）定位的近红外（NIR）光谱光学层析成像技术，研究其在区分早期乳腺癌和良性病变方面的潜在作用。
材料与方法
该方案经机构审查委员会批准，并符合 HIPAA 规定；所有参与者均签署了知情同意书。对 178 名连续接受 US 引导活检的女性（平均年龄 52 岁；范围：21-89 岁）进行了检查，使用手持式探头进行成像，该探头由一个注册的 US 换能器和一个 NIR 成像仪组成。根据注册 US 提供的病变位置来引导光学成像。测量两个光学波长的光吸收率。基于计算出的总血红蛋白浓度（tHb）评估肿瘤血管生成，并与核心活检结果相关联。对于诊断为癌且随后进行切除的患者，将 tHb 与病理参数相关联。
结果
有 2 例原位癌（Tis），35 例 T1 癌，24 例 T2-T4 癌和 114 例良性病变。Tis-T1 组的平均最大和平均 tHb 值分别为 102.0 μmol/L +/- 28.5（标准差）和 71.9 μmol/L +/- 18.8，T2-T4 组的分别为 100.3 μmol/L +/- 26.4 和 67.0 μmol/L +/- 18.3。良性组的平均最大和平均 tHb 值分别为 55.1 μmol/L +/- 22.7 和 39.1 μmol/L +/- 14.9。恶性组的平均最大和平均 tHb 值均明显高于良性组（P <.001）。Tis-T1 癌的灵敏度、特异性、阳性预测值和阴性预测值分别为 92%、93%、81%和 97%。T2-T4 肿瘤的对应值分别为 75%、93%、69%和 95%。
结论
使用超声引导的近红外（NIR）技术成像的血管生成（tHb）对比有望作为乳腺 X 线摄影和超声的辅助手段，用于区分早期浸润性乳腺癌和良性病变。
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