van der Pol Christian B, Schweitzer Mark E, Di Primio Gina, Sampaio Marcos L, Kielar Ania, Clemons Mark, Jaberi Arash
Department of Diagnostic Imaging, The Ottawa Hospital, 1053 Carling Avenue, Ottawa, ON, K1Y 4E9, Canada,
Breast Cancer Res Treat. 2014 Aug;146(3):583-9. doi: 10.1007/s10549-014-3046-z. Epub 2014 Jul 10.
The purpose of this study was to determine if bone metastasis characteristics on axial skeleton MRI are associated with either skeletal-related events (SREs) or survival in breast cancer patients. A retrospective review was performed on 247 breast cancer patients with bone metastases identified on axial skeleton MRI. MRI studies were reviewed for metastases T1 signal, signal uniformity, complete vertebral metastatic marrow replacement, metastases quantity, and distribution. Odds ratio (OR) and hazard ratios (HR) were calculated, with 95 % confidence intervals (95 % CI), to determine association with either future SREs or survival. At the time of analysis, 174 (70 %) patients had developed SREs and 176 (71 %) patients were dead. Features of skeletal metastases associated with SREs included the presence of complete metastatic marrow replacement within any vertebra; OR 2.363 (95 % CI 1.240-4.504, P = 0.0090), and more widely distributed metastases; OR 1.239 (95 % CI 1.070-1.435, P = 0.0040). Features associated with shorter survival included the presence of complete metastatic marrow replacement within any vertebra; HR 1.500 (95 % CI 1.105-2.036, P = 0.0093), and more widely distributed metastases; HR 1.141 (95 % CI 1.047-1.243, P = 0.0027). Metastases T1 signal, signal uniformity, and surprisingly quantity were not associated with SREs or survival. Axial skeleton MRI was able to identify characteristics predictive of future SREs and survival. These characteristics could be used for risk stratification for future trials if prospectively validated.
本研究的目的是确定乳腺癌患者轴向骨骼磁共振成像（MRI）上的骨转移特征是否与骨相关事件（SREs）或生存率相关。对247例经轴向骨骼MRI确诊为骨转移的乳腺癌患者进行了回顾性研究。对MRI研究进行了转移灶T1信号、信号均匀性、椎体转移性骨髓完全替代、转移灶数量和分布的评估。计算比值比（OR）和风险比（HR）以及95%置信区间（95%CI），以确定与未来SREs或生存率的相关性。在分析时，174例（70%）患者发生了SREs，176例（71%）患者死亡。与SREs相关的骨转移特征包括任何椎体存在转移性骨髓完全替代；OR为2.363（95%CI 1.240 - 4.504，P = 0.0090），以及转移灶分布更广泛；OR为1.239（95%CI 1.070 - 1.435，P = 0.0040）。与生存期较短相关的特征包括任何椎体存在转移性骨髓完全替代；HR为1.500（95%CI 1.105 - 2.036，P = 0.0093），以及转移灶分布更广泛；HR为1.141（95%CI 1.047 - 1.243，P = 0.0027）。转移灶T1信号、信号均匀性以及出人意料的转移灶数量与SREs或生存率无关。轴向骨骼MRI能够识别预测未来SREs和生存率的特征。如果经过前瞻性验证，这些特征可用于未来试验的风险分层。
