Kim Jin You, Suh Hie Bum, Kang Hyun Jung, Shin Jong Ki, Choo Ki Seok, Nam Kyung Jin, Lee Seok Won, Jung Young Lae, Bae Young Tae
Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, 1-10, Ami-Dong, Seo-gu, Pusan, 602-739, Republic of Korea.
Medical Research Institute, Pusan National University School of Medicine, Pusan, Republic of Korea.
Breast Cancer Res Treat. 2016 May;157(1):31-40. doi: 10.1007/s10549-016-3793-0. Epub 2016 Apr 18.
The purpose of this study was to investigate prospectively whether the apparent diffusion coefficients (ADCs) of both breast cancer and normal fibroglandular tissue vary with the menstrual cycle and menopausal status. Institutional review board approval was obtained, and informed consent was obtained from each participant. Fifty-seven women (29 premenopausal, 28 postmenopausal) with newly diagnosed breast cancer underwent diffusion-weighted imaging twice (interval 12-20 days) before surgery. Two radiologists independently measured ADC of breast cancer and normal contralateral breast tissue, and we quantified the differences according to the phases of menstrual cycle and menopausal status. With normal fibroglandular tissue, ADC was significantly lower in postmenopausal than in premenopausal women (P = 0.035). In premenopausal women, ADC did not differ significantly between proliferative and secretory phases in either breast cancer or normal fibroglandular tissue (P = 0.969 and P = 0.519, respectively). In postmenopausal women, no significant differences were found between ADCs measured at different time intervals in either breast cancer or normal fibroglandular tissue (P = 0.948 and P = 0.961, respectively). The within-subject variability of the ADC measurements was quantified using the coefficient of variation (CV) and was small: the mean CVs of tumor ADC were 2.90 % (premenopausal) and 3.43 % (postmenopausal), and those of fibroglandular tissue ADC were 4.37 % (premenopausal) and 2.55 % (postmenopausal). Both intra- and interobserver agreements were excellent for ADC measurements, with intraclass correlation coefficients in the range of 0.834-0.974. In conclusion, the measured ADCs of breast cancer and normal fibroglandular tissue were not affected significantly by menstrual cycle, and the measurements were highly reproducible both within and between observers.
本研究的目的是前瞻性地调查乳腺癌和正常纤维腺组织的表观扩散系数（ADC）是否随月经周期和绝经状态而变化。本研究获得了机构审查委员会的批准，并获得了每位参与者的知情同意。57例新诊断为乳腺癌的女性（29例绝经前，28例绝经后）在手术前接受了两次扩散加权成像（间隔12 - 20天）。两名放射科医生独立测量乳腺癌和对侧正常乳腺组织的ADC，我们根据月经周期阶段和绝经状态对差异进行了量化。对于正常纤维腺组织，绝经后女性的ADC显著低于绝经前女性（P = 0.035）。在绝经前女性中，乳腺癌和正常纤维腺组织在增殖期和分泌期的ADC均无显著差异（分别为P = 0.969和P = 0.519）。在绝经后女性中，乳腺癌和正常纤维腺组织在不同时间间隔测量的ADC之间均未发现显著差异（分别为P = 0.948和P = 0.961）。使用变异系数（CV）对ADC测量的受试者内变异性进行了量化，结果显示变异性较小：肿瘤ADC的平均CV在绝经前为2.90%，绝经后为3.43%，纤维腺组织ADC的平均CV在绝经前为4.37%，绝经后为2.55%。ADC测量的观察者内和观察者间一致性均极佳，组内相关系数在0.834 - 0.974范围内。总之，乳腺癌和正常纤维腺组织的测量ADC不受月经周期的显著影响，且测量在观察者内和观察者间均具有高度可重复性。
