van Uden Dominique J P, de Wilt J Hans W, Meeuwis Carla, Blanken-Peeters Charlotte F J M, Mann Ritse M
Department of Surgical Oncology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands.
Department of Radiology, Rijnstate Hospital, Arnhem, The Netherlands.
Breast Care (Basel). 2017 Sep;12(4):224-229. doi: 10.1159/000475745. Epub 2017 Aug 29.
The aim of this study was to describe the dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) features of inflammatory breast cancer (IBC) and to assess the value of DCE-MRI for the prediction of pathological complete response (pCR).
Image analysis was performed in 15 patients with IBC (cT4d) and 12 patients with non-IBC (cT2), and included the assessment of BIRADS characteristics, skin alterations, enhancement characteristics, and changes post chemotherapy. Sensitivity and specificity of DCE-MRI for the presence of residual disease were obtained. Pearson's correlation coefficients were calculated comparing the (preoperative) tumor size with the histological size.
Skin thickening/enhancement (80%) and non-mass-like enhancement (66.7%) occurred more often in IBC (16.7 vs. 8.3% in non-IBC). In 2 of 3 cases of IBC, pCR was correctly predicted (sensitivity 92%, specificity 67%), compared to 3 of 5 cases in non-IBC (sensitivity 86%, specificity 40%). Lower peak enhancement might be associated with a higher likelihood of pCR in IBC. No other parameters predicted eventual pCR. In IBC, no correlation between preoperative tumor size and histological size was found (r = 0.22, p = 0.50), whereas in non-IBC, size estimations were more accurate (r = 0.75, p = 0.03).
IBC is characterized on MRI by skin changes and non-mass-like enhancement. Radiological complete response seems indicative of pCR in IBC and non-IBC. Size estimation of residual disease in IBC appears to be inaccurate.
本研究旨在描述炎性乳腺癌（IBC）的动态对比增强磁共振成像（DCE-MRI）特征，并评估DCE-MRI对预测病理完全缓解（pCR）的价值。
对15例IBC（cT4d）患者和12例非IBC（cT2）患者进行图像分析，包括评估BIRADS特征、皮肤改变、增强特征以及化疗后的变化。获得DCE-MRI对残留疾病存在情况的敏感性和特异性。计算术前肿瘤大小与组织学大小的Pearson相关系数。
皮肤增厚/强化（80%）和非肿块样强化（66.7%）在IBC中更常见（非IBC中为16.7% vs. 8.3%）。在3例IBC患者中的2例中，pCR被正确预测（敏感性92%，特异性67%），相比之下，非IBC的5例中有3例（敏感性86%，特异性40%）。较低的峰值强化可能与IBC中pCR的可能性较高有关。没有其他参数能够预测最终的pCR。在IBC中，未发现术前肿瘤大小与组织学大小之间存在相关性（r = 0.22，p = 0.50），而在非IBC中，大小估计更准确（r = 0.75，p = 0.03）。
IBC在MRI上的特征为皮肤改变和非肿块样强化。放射学完全缓解似乎提示IBC和非IBC中的pCR。IBC中残留疾病的大小估计似乎不准确。
