Kim Eun Jeong, Kim Sung Hun, Park Ga Eun, Kang Bong Joo, Song Byung Joo, Kim Yun Ju, Lee Dongeon, Ahn Hyunsoo, Kim Inah, Son Yo Han, Grimm Robert
Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea.
Department of General Surgery, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea.
J Magn Reson Imaging. 2015 Dec;42(6):1666-78. doi: 10.1002/jmri.24934. Epub 2015 Apr 27.
To evaluate apparent diffusion coefficient (ADC) histogram parameters that show correlations with prognostic factors and subtypes of breast cancer.
At 3.0T, various ADC histogram parameters were calculated including the entire tumor volume in 173 invasive ductal carcinomas: the minimum, 10th percentile, mean, median, 90th percentile, and maximum. ADC parameters were correlated with prognostic factors and subtype.
The mean ADCmedian value was significantly higher in the group with lymph node metastasis, HER2 positivity, and a Ki-67 value <14% than in the group with negativity for lymph node metastasis, HER2 negativity, and a Ki-67 value ≥14% (0.907, 0.978, and 0.941 vs. 0.735, 0.778, and 0.761 × 10(-3) mm(2) /s, respectively) (P < 0.01). There was no significant correlation between ADCmedian and tumor size, histologic grade, estrogen receptor expression, and progesterone receptor expression (P = 0.272, 0.113, 0.261, and 0.181, respectively). For most ADC parameters except for ADCmin , the mean of variable ADC parameters of HER2-positive, luminal A, luminal B-HER2(+), triple-negative, and luminal B-HER2(-) diseases were arranged in descending order (1.175, 0.936, 0.863, 0.811, and 0.665 × 10(-3) mm(2) /s in ADCmedian , respectively) with statistical significant difference (P < 0.001). In multivariate analysis, histologic grade, the Ki-67 index, and HER2 expression were statistically significant explanatory prognostic factors for ADCmedian and the Ki-67 index had the most robust effects on ADC parameters (standardized coefficient = -0.317).
Various ADC parameters were correlated with prognostic factors and subtype, except for ADCmin . HER2 positivity showed high ADC values and high Ki-67 index revealed low ADC values.
评估与乳腺癌预后因素及亚型相关的表观扩散系数(ADC)直方图参数。
在3.0T条件下,计算173例浸润性导管癌整个肿瘤体积的各种ADC直方图参数,包括最小值、第10百分位数、均值、中位数、第90百分位数和最大值。将ADC参数与预后因素及亚型进行相关性分析。
有淋巴结转移、HER2阳性且Ki-67值<14%的组,其ADC中位数均值显著高于无淋巴结转移、HER2阴性且Ki-67值≥14%的组(分别为0.907、0.978和0.941 vs. 0.735、0.778和0.761×10⁻³ mm²/s)(P<0.01)。ADC中位数与肿瘤大小、组织学分级、雌激素受体表达及孕激素受体表达之间无显著相关性(P分别为0.272、0.113、0.261和0.181)。除ADC最小值外,对于大多数ADC参数,HER2阳性、管腔A型、管腔B-HER2(+)、三阴性和管腔B-HER2(-)疾病的可变ADC参数均值按降序排列(ADC中位数分别为1.175、0.936、0.863、0.811和0.665×10⁻³ mm²/s),差异有统计学意义(P<0.001)。多因素分析中,组织学分级、Ki-67指数和HER2表达是ADC中位数有统计学意义的解释性预后因素,且Ki-67指数对ADC参数影响最强(标准化系数=-0.317)。
除ADC最小值外,各种ADC参数与预后因素及亚型相关。HER2阳性显示高ADC值,高Ki-67指数显示低ADC值。