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超声造影在乳腺癌新辅助化疗早期疗效预测中的应用

Contrast-Enhanced Ultrasound for Early Prediction of Response of Breast Cancer to Neoadjuvant Chemotherapy.

机构信息

Radiology, Daejeon St. Mary's hospital, The Catholic University of Korea, Daejeon, Korea (the Republic of).

Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of.

出版信息

Ultraschall Med. 2019 Apr;40(2):194-204. doi: 10.1055/a-0637-1601. Epub 2018 Aug 13.

Abstract

PURPOSE

To evaluate the time-intensity curve (TIC) parameters on contrast-enhanced ultrasound (CEUS) for early prediction of the response of breast cancer to neoadjuvant chemotherapy (NAC).

MATERIALS AND METHODS

This prospective study included 41 patients with breast cancer. CEUS was performed before and after the first cycle of NAC. TIC parameters were analyzed for different regions of interest (ROIs). ROI 1 targeted the hotspot area of greatest enhancement, ROI 2 delineated the area of hyperenhancement, ROI 3 included the entire tumor on grayscale ultrasound, and ROI 4 encircled the normal parenchyma. The TIC perfusion values for ROI 1, 2, and 3 were divided by the ROI 4 value.

RESULTS

11 (26.8 %) of the 41 patients showed a good response (Miller-Payne score 4 or 5) and 30 (73.2 %) showed a minor response (Miller-Payne score 1, 2, or 3). There were significant differences in the wash-out area under the curve, the wash-in and wash-out areas under the curve on ROI 1/4 after the first cycle of NAC, pre-NAC mean transit time local (mTTl) on ROI 2/4, and pre-NAC mTTl on ROI 3/4 between good and minor responders (area under the receiver-operating characteristic curve > 0.70, p < 0.05).

CONCLUSION

Some TIC parameters obtained by CEUS may allow prediction of the response of breast cancer to NAC at a very early time point.

摘要

目的

评估对比增强超声(CEUS)时间强度曲线(TIC)参数在预测乳腺癌新辅助化疗(NAC)早期疗效中的价值。

材料与方法

本前瞻性研究纳入 41 例乳腺癌患者。所有患者均在 NAC 前及第 1 周期后进行 CEUS 检查。分析不同感兴趣区(ROI)的 TIC 参数。ROI1 靶向强化最明显的热点区域,ROI2 描绘高强化区域,ROI3 包括灰阶超声上的整个肿瘤,ROI4 则环绕正常实质。ROI1、2 和 3 的 TIC 灌注值除以 ROI4 值。

结果

41 例患者中,11 例(26.8%)疗效良好(Miller-Payne 评分 4 或 5 分),30 例(73.2%)疗效一般(Miller-Payne 评分 1、2 或 3 分)。NAC 第 1 周期后 ROI1/4 的廓清面积、灌注曲线下面积及灌注曲线下面积,NAC 前 ROI2/4 的达峰时间(mTTl)及 ROI3/4 的 mTTl 在疗效良好与一般患者之间存在显著差异(ROC 曲线下面积>0.70,p<0.05)。

结论

CEUS 获得的某些 TIC 参数可能有助于在非常早期预测乳腺癌对 NAC 的反应。

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