Choi Joon Ho, Lim Ilhan, Noh Woo Chul, Kim Hyun-Ah, Seong Min-Ki, Jang Seonah, Seol Hyesil, Moon Hansol, Byun Byung Hyun, Kim Byung Il, Choi Chang Woon, Lim Sang Moo
Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea.
Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, Republic of Korea.
Ann Nucl Med. 2018 Jul;32(6):389-397. doi: 10.1007/s12149-018-1259-7. Epub 2018 May 23.
The aim of this study is to assess tumor differentiation using parameters from sequential positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) in patients with breast cancer.
This retrospective study included 78 patients with breast cancer. All patients underwent sequential PET/CT and MRI. For fluorodeoxyglucose (FDG)-PET image analysis, the maximum standardized uptake value (SUV) of FDG was assessed at both 1 and 2 h and metabolic tumor volume (MTV) and total lesion glycolysis (TLG). The kinetic analysis of dynamic contrast-enhanced MRI parameters was performed using dynamic enhancement curves. We assessed diffusion-weighted imaging (DWI)-MRI parameters regarding apparent diffusion coefficient (ADC) values. Histologic grades 1 and 2 were classified as low-grade, and grade 3 as high-grade tumor.
Forty-five lesions of 78 patients were classified as histologic grade 3, while 26 and 7 lesions were grade 2 and grade 1, respectively. Patients with high-grade tumors showed significantly lower ADC-mean values than patients with low-grade tumors (0.99 ± 0.19 vs.1.12 ± 0.32, p = 0.007). With respect to SUV1, MTV2.5, and TLG2.5, patients with high-grade tumors showed higher values than patients with low-grade tumors: SUV1 (7.92 ± 4.5 vs.6.19 ± 3.05, p = 0.099), MTV2.5 (7.90 ± 9.32 vs.4.38 ± 5.10, p = 0.095), and TLG2.5 (40.83 ± 59.17 vs.19.66 ± 26.08, p = 0.082). However, other parameters did not reveal significant differences between low-grade and high-grade malignancies. In receiver-operating characteristic (ROC) curve analysis, ADC-mean values showed the highest area under the curve of 0.681 (95%CI 0.566-0.782) for assessing high-grade malignancy.
Lower ADC-mean values may predict the poor differentiation of breast cancer among diverse PET-MRI functional parameters.
本研究旨在利用序贯正电子发射断层扫描/计算机断层扫描（PET/CT）和磁共振成像（MRI）的参数评估乳腺癌患者的肿瘤分化情况。
这项回顾性研究纳入了78例乳腺癌患者。所有患者均接受了序贯PET/CT和MRI检查。对于氟脱氧葡萄糖（FDG）-PET图像分析，在1小时和2小时时评估FDG的最大标准化摄取值（SUV）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）。使用动态增强曲线对动态对比增强MRI参数进行动力学分析。我们评估了扩散加权成像（DWI）-MRI关于表观扩散系数（ADC）值的参数。组织学1级和2级被分类为低级别肿瘤，3级为高级别肿瘤。
78例患者中的45个病灶被分类为组织学3级，而26个和7个病灶分别为2级和1级。高级别肿瘤患者的ADC平均值显著低于低级别肿瘤患者（0.99±0.19对1.12±0.32，p = 0.007）。关于SUV1、MTV2.5和TLG2.5，高级别肿瘤患者的值高于低级别肿瘤患者：SUV1（7.92±4.5对6.19±3.05，p = 0.099），MTV2.5（7.90±9.32对4.38±5.10，p = 0.095），以及TLG2.5（40.83±59.17对19.66±26.08，p = 0.082）。然而，其他参数在低级别和高级别恶性肿瘤之间未显示出显著差异。在受试者操作特征（ROC）曲线分析中，ADC平均值在评估高级别恶性肿瘤时显示出最高的曲线下面积，为0.681（95%CI 0.566 - 0.782）。
在各种PET-MRI功能参数中，较低的ADC平均值可能预示着乳腺癌的低分化。
