自动乳腺容积扫描仪（ABVS）在监测乳腺癌患者新辅助治疗肿瘤反应中的作用：初步结果。
Usefulness of automated breast volume scanner (ABVS) for monitoring tumor response to neoadjuvant treatment in breast cancer patients: preliminary results.
机构信息
Dipartimento di Scienze Radiologiche, Istituto di Radiologia, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
出版信息
Eur Rev Med Pharmacol Sci. 2019 Jan;23(1):225-231. doi: 10.26355/eurrev_201901_16768.
OBJECTIVE
We investigated the accuracy of Automated Breast Volume Scanner (ABVS) compared to handheld ultrasound (HHUS) for monitoring tumor response to neoadjuvant treatment (NAT) in breast cancer (BC).
PATIENTS AND METHODS
All the patients submitted to biopsy in our Institution, from January 2017 to May 2017, proven invasive BC and eligible for NAT, were enrolled in this prospective study. The participants underwent ABVS, HHUS, dynamic contrast-enhanced Magnetic Resonance Imaging (DCE-MRI) and mammography at the beginning of NAT and ABVS, HHUS and DCE-MRI at the halfway point of therapy and before the surgery. DCE-MRI was considered the standard of reference. Two breast radiologists (R1, R2), with fifteen and five years of experience in breast imaging, independently assigned a visibility score (ordinal 5-point scale) to ABVS, HHUS, and DCE-MRI. Diagnostic performance of ABVS and HHUS as measured by sensitivity, specificity, positive and negative predictive values (PPV and NPV) was calculated. Correlations between ABVS and MRI, and between HHUS and MRI were analyzed using Pearson's correlation test.
RESULTS
A total of 21 patients were enrolled. 189 examinations were performed. The comparison between ABVS and DCE-MRI was similar for the both readers: ABVS had a sensitivity of 63,16%, specificity of 83,58%, PPV of 76,60%, NPV of 72,73%, accuracy of 74,19% (R1) and a sensitivity of 54.54%, specificity of 85.51%, PPV of 75%, NPV of 70,24%, accuracy of 71.77% (R2). The comparison between HHUS and DCE-MRI showed that HHUS had a sensitivity of 63,16 %, specificity of 83,58%, PPV of 76,60%, NPV of 72,73%, accuracy of 74,19% (R1) and a sensitivity of 36.84%, specificity of 85.07%, PPV of 67.74%, NPV of 61.29%, accuracy of 62.90% (R2). The calculated Pearson's correlation coefficient r values were 7.8 for HHUS vs. DCE-MRI and 28.5 for ABVS vs. DCE-MRI (R1) and 7.8 for HHUS vs. DCE-MRI and 22.4 for ABVS vs. DCE-MRI (R2). Statistical significance of ABVS and HHUS was p < 0.0001 and 0.005 < p < 0.01, respectively (R1, R2).
CONCLUSIONS
DCE-MRI is recommended for the tumor response assessment. ABVS, a product of the biotechnology development, providing reproducible images, in addition to DCE-MRI, can be a potentially useful tool for the monitoring of response to NAT.
目的
我们研究了自动乳腺容积扫描仪（ABVS）与手持超声（HHUS）在监测乳腺癌（BC）新辅助治疗（NAT）中肿瘤反应的准确性。
方法
我们对 2017 年 1 月至 2017 年 5 月在我院接受活检的所有患者进行了前瞻性研究，这些患者均为浸润性 BC 且符合 NAT 条件。患者在 NAT 开始时、治疗半程时以及手术前分别接受 ABVS、HHUS、动态对比增强磁共振成像（DCE-MRI）和乳房 X 线摄影检查。DCE-MRI 被视为标准参考。两位有 15 年和 5 年乳腺影像学经验的乳腺放射科医生（R1、R2）对 ABVS、HHUS 和 DCE-MRI 的可视性评分（5 分序数值）进行了独立评估。计算 ABVS 和 HHUS 的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）以评估其诊断性能。使用 Pearson 相关检验分析 ABVS 和 MRI 之间以及 HHUS 和 MRI 之间的相关性。
结果
共纳入 21 例患者，共进行了 189 次检查。两位放射科医生的 ABVS 与 DCE-MRI 比较结果相似：ABVS 的敏感性为 63.16%，特异性为 83.58%，PPV 为 76.60%，NPV 为 72.73%，准确性为 74.19%（R1）和敏感性为 54.54%，特异性为 85.51%，PPV 为 75%，NPV 为 70.24%，准确性为 71.77%（R2）。HHUS 与 DCE-MRI 的比较结果显示，HHUS 的敏感性为 63.16%，特异性为 83.58%，PPV 为 76.60%，NPV 为 72.73%，准确性为 74.19%（R1）和敏感性为 36.84%，特异性为 85.07%，PPV 为 67.74%，NPV 为 61.29%，准确性为 62.90%（R2）。计算的 Pearson 相关系数 r 值分别为 HHUS 与 DCE-MRI 之间的 7.8 和 ABVS 与 DCE-MRI 之间的 28.5（R1）和 HHUS 与 DCE-MRI 之间的 7.8 和 ABVS 与 DCE-MRI 之间的 22.4（R2）。ABVS 和 HHUS 的统计学显著性为 p < 0.0001 和 0.005 < p < 0.01（R1、R2）。
结论
推荐使用 DCE-MRI 进行肿瘤反应评估。ABVS 是生物技术发展的产物，提供了可重复的图像，除 DCE-MRI 外，还可以成为监测 NAT 反应的有用工具。
Zotero 插件