在 3.0T 的 T2 加权 MRI 上使用熵纹理特征测量的中期异质性变化与原发性乳腺癌新辅助化疗的病理反应相关。

Interim heterogeneity changes measured using entropy texture features on T2-weighted MRI at 3.0 T are associated with pathological response to neoadjuvant chemotherapy in primary breast cancer.

机构信息

Department of Medical Physics, Ninewells Hospital and Medical School, Dundee, UK, DD1 9SY.

Department of Pathology, Ninewells Hospital and Medical School, Dundee, UK, DD1 9SY.

出版信息

Eur Radiol. 2017 Nov;27(11):4602-4611. doi: 10.1007/s00330-017-4850-8. Epub 2017 May 18.

OBJECTIVES

To investigate whether interim changes in hetereogeneity (measured using entropy features) on MRI were associated with pathological residual cancer burden (RCB) at final surgery in patients receiving neoadjuvant chemotherapy (NAC) for primary breast cancer.

METHODS

This was a retrospective study of 88 consenting women (age: 30-79 years). Scanning was performed on a 3.0 T MRI scanner prior to NAC (baseline) and after 2-3 cycles of treatment (interim). Entropy was derived from the grey-level co-occurrence matrix, on slice-matched baseline/interim T2-weighted images. Response, assessed using RCB score on surgically resected specimens, was compared statistically with entropy/heterogeneity changes and ROC analysis performed. Association of pCR within each tumour immunophenotype was evaluated.

RESULTS

Mean entropy percent differences between examinations, by response category, were: pCR: 32.8%, RCB-I: 10.5%, RCB-II: 9.7% and RCB-III: 3.0%. Association of ultimate pCR with coarse entropy changes between baseline/interim MRI across all lesions yielded 85.2% accuracy (area under ROC curve: 0.845). Excellent sensitivity/specificity was obtained for pCR prediction within each immunophenotype: ER+: 100%/100%; HER2+: 83.3%/95.7%, TNBC: 87.5%/80.0%.

CONCLUSIONS

Lesion T2 heterogeneity changes are associated with response to NAC using RCB scores, particularly for pCR, and can be useful across all immunophenotypes with good diagnostic accuracy.

KEY POINTS

• Texture analysis provides a means of measuring lesion heterogeneity on MRI images. • Heterogeneity changes between baseline/interim MRI can be linked with ultimate pathological response. • Heterogeneity changes give good diagnostic accuracy of pCR response across all immunophenotypes. • Percentage reduction in heterogeneity is associated with pCR with good accuracy and NPV.

目的

研究在接受新辅助化疗（NAC）的原发性乳腺癌患者中，MRI 上异质性（用熵特征测量）的中期变化是否与最终手术时的病理残留癌负担（RCB）相关。

方法

这是一项对 88 名同意参加的女性（年龄 30-79 岁）的回顾性研究。在 NAC 前（基线）和治疗 2-3 个周期后（中期），在 3.0T MRI 扫描仪上进行扫描。在切片匹配的基线/中期 T2 加权图像上，从灰度共生矩阵中得出熵。使用手术切除标本上的 RCB 评分评估反应，并进行统计学比较和 ROC 分析。评估每个肿瘤免疫表型内的 pCR 相关性。

结果

根据反应类别，两次检查之间的平均熵百分比差异为：pCR：32.8%，RCB-I：10.5%，RCB-II：9.7%和 RCB-III：3.0%。在所有病变中，将基线/中期 MRI 之间的最终 pCR 与粗熵变化相关联，可获得 85.2%的准确性（ROC 曲线下面积：0.845）。在每个免疫表型中，pCR 预测均获得了优异的灵敏度/特异性：ER+：100%/100%；HER2+：83.3%/95.7%，TNBC：87.5%/80.0%。