Lagendijk M, Vos E L, Ramlakhan K P, Verhoef C, Koning A H J, van Lankeren W, Koppert L B
Department of Surgical Oncology, Erasmus MC Cancer Institute, Groene Hilledijk 301, 3075 EA, Rotterdam, The Netherlands.
Department of Surgical Oncology, Erasmus MC Cancer Institute, PO Box 5201, 3008 AE, Rotterdam, The Netherlands.
World J Surg. 2018 Jul;42(7):2087-2093. doi: 10.1007/s00268-017-4432-6.
The resection volume in relation to the breast volume is known to influence cosmetic outcome following breast-conserving therapy. It was hypothesised that three-dimensional ultrasonography (3-D US) could be used to preoperatively assess breast and tumour volume and show high association with histopathological measurements.
Breast volume by the 3D-US was compared to the water displacement method (WDM), mastectomy specimen weight, 3-D MRI and three different calculations for breast volume on mammography. Tumour volume by the 3-D US was compared to the histopathological tumour volume and 3-D MRI. Relatedness was based on the intraclass correlation coefficient (ICC) with corresponding 95% confidence interval (95% CI). Bland-Altman plots were used to graphically display the agreement for the different assessment techniques. All measurements were performed by one observer.
A total of 36 patients were included, 20 and 23 for the evaluation of breast and tumour volume (ductal invasive carcinomas), respectively. 3-D US breast volume showed 'excellent' association with WDM, ICC 0.92 [95% CI (0.80-0.97)]. 3-D US tumour volume showed a 'excellent' association with histopathological tumour volume, ICC 0.78 [95% CI (0.55-0.91)]. Bland-Altman plots showed an increased overestimation in lager tumour volumes measured by 3-D MRI compared to histopathological volume.
3-D US showed a high association with gold standard WDM for the preoperative assessment of breast volume and the histopathological measurement of tumour volume. 3-D US is an patient-friendly preoperative available technique to calculate both breast volume and tumour volume. Volume measurements are promising in outcome prediction of intended breast-conserving treatment.
已知保乳治疗后乳房切除体积与乳房体积的关系会影响美容效果。据推测,三维超声检查(3-D US)可用于术前评估乳房和肿瘤体积,并与组织病理学测量结果高度相关。
将3-D US测量的乳房体积与水置换法(WDM)、乳房切除标本重量、3-D MRI以及乳房X线摄影术上三种不同的乳房体积计算方法进行比较。将3-D US测量的肿瘤体积与组织病理学肿瘤体积和3-D MRI进行比较。相关性基于组内相关系数(ICC)及相应的95%置信区间(95%CI)。采用Bland-Altman图以图形方式展示不同评估技术之间的一致性。所有测量均由一名观察者进行。
共纳入36例患者,分别有20例和23例用于评估乳房体积和肿瘤体积(导管浸润癌)。3-D US测量的乳房体积与WDM显示出“极佳”的相关性,ICC为0.92 [95%CI(0.80 - 0.97)]。3-D US测量的肿瘤体积与组织病理学肿瘤体积显示出“极佳”的相关性,ICC为0.78 [95%CI(0.55 - 0.91)]。Bland-Altman图显示,与组织病理学体积相比,3-D MRI测量的较大肿瘤体积存在更高的高估情况。
3-D US在术前评估乳房体积和肿瘤体积的组织病理学测量方面与金标准WDM显示出高度相关性。3-D US是一种患者友好的术前可用技术,可用于计算乳房体积和肿瘤体积。体积测量在预期保乳治疗的结果预测方面很有前景。