O'Flynn Elizabeth A M, Wilson Robin M, Allen Steven D, Locke Imogen, Scurr Erica, deSouza Nandita M
Clinical Magnetic Resonance Group, Cancer Research UK and EPSRC Cancer Imaging Centre, Royal Marsden NHS Foundation Trust, Downs Road, Sutton, Surrey, United Kingdom.
J Magn Reson Imaging. 2014 Apr;39(4):805-11. doi: 10.1002/jmri.24243. Epub 2013 Sep 13.
To document the apparent diffusion coefficient (ADC) of fibroglandular breast tissue in women at high-risk of developing breast cancer and investigate the relationship between ADC and breast density.
Local research ethics approval was obtained. A total of 33 high-risk women including 17 BRCA1/2 mutation carriers (mean age, 43 years) and 16 women postmantle irradiation (mean age 40 years) underwent diffusion-weighted MRI between days 6 and 16 of their menstrual cycle. ADC histograms from a region of interest in fibroglandular tissue and mammographic breast density measurements were obtained. Mean, percentile ADC values (10th, 25th, 50th, 75th, 90th) and skew were compared for the two groups; ADC and mammographic breast density were correlated.
Mean ADC values (×10(-6) mm(2) /s) were 2017 ± 197 in postmantle irradiated women and 1827 ± 289 in BRCA1/2 mutation carriers (P = 0.035) with significant differences at all percentiles (P < 0.0001) but not skew (P = 0.44). ADC values showed weak positive correlation with mammographic breast density in BRCA1/2 mutation carriers (r = 0.51, P = 0.043) but not in postmantle radiotherapy patients (r = 0.49, P = 0.13).
Higher ADC values seen in fibroglandular tissue postmantle irradiation compared with BRCA1/2 mutation carriers has potential to improve tumor detection in these patients. Lack of correlation between ADC and breast density postmantle irradiation may be a result of microstructural changes.
记录乳腺癌高危女性纤维腺性乳腺组织的表观扩散系数（ADC），并研究ADC与乳腺密度之间的关系。
获得当地研究伦理批准。共有33名高危女性，包括17名BRCA1/2突变携带者（平均年龄43岁）和16名接受斗篷野放疗后的女性（平均年龄40岁），在月经周期的第6至16天接受了扩散加权磁共振成像。获取纤维腺性组织感兴趣区域的ADC直方图和乳腺钼靶密度测量值。比较两组的平均、百分位数ADC值（第10、25、50、75、90百分位数）和偏度；分析ADC与乳腺钼靶密度的相关性。
接受斗篷野放疗的女性平均ADC值（×10(-6) mm(2)/s）为2017±197，BRCA1/2突变携带者为1827±289（P = 0.035），所有百分位数均存在显著差异（P < 0.0001），但偏度无差异（P = 0.44）。在BRCA1/2突变携带者中，ADC值与乳腺钼靶密度呈弱正相关（r = 0.51，P = 0.043），而在接受斗篷野放疗的患者中无相关性（r = 0.49，P = 0.13）。
与BRCA1/2突变携带者相比，斗篷野放疗后纤维腺性组织中较高的ADC值可能有助于提高这些患者肿瘤的检测率。斗篷野放疗后ADC与乳腺密度缺乏相关性可能是微观结构变化的结果。
