Bedair Reem, Priest Andrew N, Patterson Andrew J, McLean Mary A, Graves Martin J, Manavaki Roido, Gill Andrew B, Abeyakoon Oshaani, Griffiths John R, Gilbert Fiona J
Department of Radiology, School of Clinical Medicine, University of Cambridge, Box 218, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK.
Department of Radiology, Addenbrookes Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.
Eur Radiol. 2017 Jul;27(7):2726-2736. doi: 10.1007/s00330-016-4630-x. Epub 2016 Oct 31.
To assess the feasibility of the mono-exponential, bi-exponential and stretched-exponential models in evaluating response of breast tumours to neoadjuvant chemotherapy (NACT) at 3 T.
Thirty-six female patients (median age 53, range 32-75 years) with invasive breast cancer undergoing NACT were enrolled for diffusion-weighted MRI (DW-MRI) prior to the start of treatment. For assessment of early response, changes in parameters were evaluated on mid-treatment MRI in 22 patients. DW-MRI was performed using eight b values (0, 30, 60, 90, 120, 300, 600, 900 s/mm). Apparent diffusion coefficient (ADC), tissue diffusion coefficient (D ), vascular fraction (ƒ), distributed diffusion coefficient (DDC) and alpha (α) parameters were derived. Then t tests compared the baseline and changes in parameters between response groups. Repeatability was assessed at inter- and intraobserver levels.
All patients underwent baseline MRI whereas 22 lesions were available at mid-treatment. At pretreatment, mean diffusion coefficients demonstrated significant differences between groups (p < 0.05). At mid-treatment, percentage increase in ADC and DDC showed significant differences between responders (49 % and 43 %) and non-responders (21 % and 32 %) (p = 0.03, p = 0.04). Overall, stretched-exponential parameters showed excellent repeatability.
DW-MRI is sensitive to baseline and early treatment changes in breast cancer using non-mono-exponential models, and the stretched-exponential model can potentially monitor such changes.
• Baseline diffusion coefficients demonstrated significant differences between complete pathological responders and non-responders. • Increase in ADC and DDC at mid-treatment can discriminate responders and non-responders. • The ƒ fraction at mid-treatment decreased in responders whereas increased in non-responders. • The mono- and stretched-exponential models showed excellent inter- and intrarater repeatability. • Treatment effects can potentially be assessed by non-mono-exponential diffusion models.
评估单指数、双指数和拉伸指数模型在3T磁共振成像（MRI）下评估乳腺肿瘤对新辅助化疗（NACT）反应的可行性。
36例接受NACT的浸润性乳腺癌女性患者（中位年龄53岁，范围32 - 75岁）在治疗开始前接受扩散加权MRI（DW-MRI）检查。为评估早期反应，对22例患者治疗中期的MRI参数变化进行评估。DW-MRI使用8个b值（0、30、60、90、120、300、600、900 s/mm²）进行。得出表观扩散系数（ADC）、组织扩散系数（D）、血管分数（ƒ）、分布扩散系数（DDC）和α参数。然后采用t检验比较反应组之间的基线和参数变化。在观察者间和观察者内水平评估重复性。
所有患者均接受了基线MRI检查，而22个病灶在治疗中期可供分析。治疗前，各扩散系数在组间显示出显著差异（p < 0.05）。治疗中期，ADC和DDC的百分比增加在反应者（49%和43%）与无反应者（21%和32%）之间显示出显著差异（p = 0.03，p = 0.04）。总体而言，拉伸指数模型参数显示出极好的重复性。
使用非单指数模型的DW-MRI对乳腺癌的基线和早期治疗变化敏感，拉伸指数模型有可能监测此类变化。
• 完全病理反应者和无反应者之间的基线扩散系数存在显著差异。
• 治疗中期ADC和DDC的增加可区分反应者和无反应者。
• 治疗中期反应者的ƒ分数降低，而无反应者增加。
• 单指数和拉伸指数模型在观察者间和观察者内显示出极好的重复性。
• 治疗效果可能通过非单指数扩散模型进行评估。
Zotero 插件
