Luo Jing, Johnston Brian S, Kitsch Averi E, Hippe Daniel S, Korde Larissa A, Javid Sara, Lee Janie M, Peacock Sue, Lehman Constance D, Partridge Savannah C, Rahbar Habib
From the Departments of Radiology (J.L., B.S.J., A.E.K., D.S.H., J.M.L., S.P., S.C.P., H.R.), Medicine, Division of Oncology (L.A.K.), and Surgery, Division of Surgical Oncology (S.J.), University of Washington School of Medicine, Seattle Cancer Care Alliance, 825 Eastlake Ave East, Seattle, WA 98109-1023; and Department of Radiology, Massachusetts General Hospital, Boston, Mass (C.D.L.).
Radiology. 2017 Dec;285(3):788-797. doi: 10.1148/radiol.2017170587. Epub 2017 Sep 14.
Purpose To investigate whether specific imaging features on breast magnetic resonance (MR) images are associated with ductal carcinoma in situ (DCIS) recurrence risk after definitive treatment. Materials and Methods Patients with DCIS who underwent preoperative dynamic contrast material-enhanced (DCE) MR imaging between 2004 and 2014 with ipsilateral recurrence more than 6 months after definitive surgical treatment were retrospectively identified. For each patient, a control subject with DCIS that did not recur was identified and matched on the basis of clinical, histopathologic, and treatment features known to affect recurrence risk. On DCE MR images, lesion characteristics (longest diameter, functional tumor volume [FTV], peak percentage enhancement [PE], peak signal enhancement ratio [SER], and washout fraction) and normal tissue features (background parenchymal enhancement [BPE] volume, mean BPE) were quantitatively measured. MR imaging features were compared between patients and control subjects by using the Wilcoxon signed-rank test, with adjustment for multiple comparisons. Results Of 415 subjects with DCIS who underwent preoperative MR imaging, 14 experienced recurrence and 11 had an identifiable matching control subject (final cohort, 11 patients and 11 control subjects). Median time to recurrence was 14 months, and median follow-up for control subjects was 102 months. When compared with matched control subjects, patients with DCIS recurrence exhibited significantly greater FTV (median, 9.3 cm vs 1.3 cm, P = .01), lesion peak SER (median, 1.7 vs 1.2; P = .03), and mean BPE (median, 58.3% vs 41.1%; P = .02). Conclusion Quantitative lesion and normal breast tissue characteristics at preoperative MR imaging in women with newly diagnosed DCIS show promise for association with breast cancer recurrence after treatment. RSNA, 2017.
目的 探讨乳腺磁共振（MR）图像上的特定影像学特征是否与导管原位癌（DCIS）根治性治疗后的复发风险相关。材料与方法 回顾性纳入2004年至2014年间接受术前动态对比剂增强（DCE）MR成像检查的DCIS患者，这些患者在根治性手术治疗后6个月以上出现同侧复发。为每位患者确定一名未复发的DCIS对照受试者，并根据已知会影响复发风险的临床、组织病理学和治疗特征进行匹配。在DCE MR图像上，定量测量病变特征（最长径、功能肿瘤体积[FTV]、峰值增强百分比[PE]、峰值信号增强率[SER]和廓清率）和正常组织特征（背景实质强化[BPE]体积、平均BPE）。采用Wilcoxon符号秩检验比较患者与对照受试者之间的MR成像特征，并对多重比较进行校正。结果 在415例接受术前MR成像检查的DCIS受试者中，14例出现复发，11例有可识别的匹配对照受试者（最终队列，11例患者和11例对照受试者）。复发的中位时间为14个月，对照受试者的中位随访时间为102个月。与匹配的对照受试者相比，DCIS复发患者的FTV明显更大（中位数，9.3 cm对1.3 cm，P = 0.01）、病变峰值SER更高（中位数，1.7对1.2；P = 0.03）和平均BPE更高（中位数，58.3%对41.1%；P = 0.02）。结论 新诊断的DCIS女性患者术前MR成像上的定量病变和正常乳腺组织特征有望与治疗后乳腺癌复发相关。RSNA，2017年。
