在 3.0T 弥散加权磁共振成像中，雌激素受体阳性且淋巴结阴性的浸润性乳腺癌的表观扩散系数：一种用于预测 Oncotype DX 试验复发评分的潜在指标。
Apparent diffusion coefficient in estrogen receptor-positive and lymph node-negative invasive breast cancers at 3.0T DW-MRI: A potential predictor for an oncotype Dx test recurrence score.
机构信息
Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
出版信息
J Magn Reson Imaging. 2018 Feb;47(2):401-409. doi: 10.1002/jmri.25796. Epub 2017 Jun 22.
PURPOSE
To measure the apparent diffusion coefficient (ADC) values in estrogen receptor-positive (ER+) and axillary lymph node-negative (LN-) invasive breast cancer and investigate the correlation of ADC with Oncotype Dx test recurrence scores (ODxRS).
MATERIALS AND METHODS
This was a Health Insurance Portability and Accountability Act (HIPAA)-compliant single-site retrospective study. Patients underwent preoperative 3.0T MRI scans with additional diffusion-weighted imaging sequential scans (b = 0, 600 and b = 0, 1000 s/mm ) from January 2011 to 2013. The study population included 31 ER+/LN- invasive breast cancers, which underwent ODxRS genomic testing. ADC and ADC parametric maps were generated, and ADC values were calculated from a user-drawn region of interest. ODxRS predicts 10-year recurrence risk in individual patients: low (RS <18), intermediate (RS: 18-30), or high (RS >30). All breast lesions, including subgroups of invasive ductal carcinoma (IDC) lesions and mass-only lesions were dichotomized by RS scores, low-risk versus intermediate/high-risk, and statistical analysis was performed using Mann-Whitney's test (statistical significance at P < 0.05) and receiver operating characteristic (ROC) curves. Multivariate analysis was also performed.
RESULTS
Invasive breast cancers, when scored as low-risk by ODxRS, had significantly higher ADC values compared with intermediate/high-risk lesions for both ADC (P = 0.007) and ADC (P = 0.008) mean values. This was true both when analyzing only mass-lesions (P = 0.03 and 0.01) or only IDCs (P = 0.001 and 0.009).
CONCLUSION
Preliminary findings suggest that lesion ADC values correlate with recurrence risk likelihood stratified using ODxRS. Hence, ADC is a potential surrogate biomarker for tumor aggressiveness.
LEVEL OF EVIDENCE
3 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018;47:401-409.
目的
测量雌激素受体阳性（ER+）且腋窝淋巴结阴性（LN-）浸润性乳腺癌的表观扩散系数（ADC）值，并探讨 ADC 与 Oncotype Dx 试验复发评分（ODxRS）的相关性。
材料与方法
这是一项符合《健康保险携带和责任法案》（HIPAA）的单站点回顾性研究。患者于 2011 年 1 月至 2013 年期间行术前 3.0T MRI 扫描，同时行附加的扩散加权成像序列扫描（b=0、600 和 b=0、1000 s/mm ）。研究人群包括 31 例接受 ODxRS 基因组检测的 ER+/LN-浸润性乳腺癌患者。生成 ADC 和 ADC 参数图，并从用户绘制的感兴趣区计算 ADC 值。ODxRS 预测个体患者 10 年复发风险：低（RS<18）、中（RS：18-30）或高（RS>30）。所有乳腺病变，包括浸润性导管癌（IDC）病变和仅肿块病变亚组，根据 RS 评分分为低危与中/高危，采用曼-惠特尼检验（P<0.05 为统计学显著）和受试者工作特征（ROC）曲线进行统计学分析。还进行了多变量分析。
结果
当根据 ODxRS 评分判断为低危时，浸润性乳腺癌的 ADC 值明显高于中/高危病变，ADC（P=0.007）和 ADCmean 值（P=0.008）均如此。这在仅分析肿块病变（P=0.03 和 0.01）或仅 IDC（P=0.001 和 0.009）时也是如此。
结论
初步研究结果表明，病变 ADC 值与使用 ODxRS 分层的复发风险可能性相关。因此，ADC 是肿瘤侵袭性的潜在替代生物标志物。
证据水平
3 技术功效：第 5 级 J. 磁共振成像 2018；47：401-409
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