新辅助内分泌治疗与新辅助化疗后残余肿瘤大小的 MRI 评估。

MRI evaluation of residual tumor size after neoadjuvant endocrine therapy vs. neoadjuvant chemotherapy.

机构信息

Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawaharacho, Sakyoku, Kyoto 606-8507, Japan.

出版信息

Eur J Radiol. 2012 Sep;81(9):2148-53. doi: 10.1016/j.ejrad.2011.05.013. Epub 2011 Jun 12.

DOI:10.1016/j.ejrad.2011.05.013

PMID:21664779

Abstract

AIM

To investigate if there is any difference in evaluation of residual tumor size after neoadjuvant chemotherapy (NAC) and neoadjuvant endocrine therapy (NAE).

METHODS

Seventy-eight tumors in 57 patients were prospectively enrolled. Residual tumor sizes in contrast-enhanced MRI after NAC and NAE were compared with those measured on surgical specimen by using linear regression analyses. The line slope values >1 indicates overestimation by MRI. Differences in types of shrinkage patterns: concentric shrinkage (CS) and dendritic shrinkage (DS) were also investigated.

RESULTS

Fifty lesions were treated with NAC and 28 lesions were treated with NAE. Shrinkage patterns were CS in 33 lesions and in 45 lesions. The slopes values were 0.75 (R=0.92) and 0.70 (R=0.90) for NAC and NAE, respectively, and no significant difference was observed (p=0.46). However, they were 1.02 (R=0.92) and 0.68 (R=0.92), respectively for CS and DS with significant difference (p<0.01). The difference between CS and DS was found only in a subgroup with size by MRI >20 mm.

CONCLUSION

Contrast enhanced MRI enabled fairly accurate measurement in NAE as well as in NAC.

摘要

目的

探讨新辅助化疗（NAC）和新辅助内分泌治疗（NAE）后残余肿瘤大小评估是否存在差异。

方法

前瞻性纳入 57 例患者的 78 个肿瘤。通过线性回归分析比较 NAC 和 NAE 后增强 MRI 上的残余肿瘤大小与手术标本上测量的残余肿瘤大小。线斜率值>1 表示 MRI 高估。还研究了收缩模式类型的差异：同心收缩（CS）和树突状收缩（DS）。

结果

50 个病变接受 NAC 治疗，28 个病变接受 NAE 治疗。收缩模式为 CS 的有 33 个病变，为 DS 的有 45 个病变。NAC 和 NAE 的斜率值分别为 0.75（R=0.92）和 0.70（R=0.90），差异无统计学意义（p=0.46）。然而，CS 和 DS 的斜率值分别为 1.02（R=0.92）和 0.68（R=0.92），差异有统计学意义（p<0.01）。仅在 MRI 大小>20mm 的亚组中发现 CS 和 DS 之间存在差异。