The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University, 54 Youdian Road, Hangzhou, 310006, China.
Breast Cancer Res Treat. 2019 Oct;177(3):629-639. doi: 10.1007/s10549-019-05342-5. Epub 2019 Jul 19.
The importance of breast cancer screening has long been known. Unfortunately, there is no imaging modality for screening women with dense breasts that is both sensitive and without concerns regarding potential side effects. The purpose of this study is to explore the possibility of combined diffusion-weighted imaging and turbo inversion recovery magnitude MRI (DWI + TIRM) to overcome the difficulty of detection sensitivity and safety.
One hundred and seventy-six breast lesions from 166 women with dense breasts were retrospectively evaluated. The lesion visibility, area under the curve (AUC), sensitivity and specificity of cancer detection by MG, DWI + TIRM, and clinical MRI were evaluated and compared. MG plus clinical MRI served as the gold standard for lesion detection and pathology served as the gold standard for cancer detection.
Lesion visibility of DWI + TIRM (96.6%) was significantly superior to MG (67.6%) in women with dense breasts (p < 0.001). There was no significant difference compared with clinical MRI. DWI + TIRM showed higher accuracy (AUC = 0.935) and sensitivity (93.68%) for breast cancer detection than MG (AUC = 0.783, sensitivity = 46.32%), but was comparable to clinical MRI (AUC = 0.944, sensitivity = 93.68%). The specificity of DWI + TIRM (83.95%) was lower than MG (98.77%), but higher than clinical MRI (77.78%).
DWI combined with TIRM could be a safe, sensitive, and practical alternative for screening women with dense breasts.
乳腺癌筛查的重要性早已为人所知。不幸的是，对于致密乳腺的女性筛查，目前还没有一种既能提高检出灵敏度又没有潜在副作用顾虑的影像学方法。本研究旨在探讨联合扩散加权成像和涡轮反转恢复幅度磁共振成像（DWI+TIRM）的可能性，以克服检测灵敏度和安全性方面的困难。
回顾性分析 166 例致密乳腺女性 176 个乳腺病变。评估磁共振弥散加权成像（DWI）+反转恢复幅度（TIRM）、常规磁共振（MG）和临床 MRI 对病灶显示率、曲线下面积（AUC）、对癌灶的检出率和特异度，并进行比较。MG 联合临床 MRI 作为病灶检测的金标准，病理结果作为癌症检测的金标准。
DWI+TIRM 对致密乳腺病变的显示率（96.6%）明显优于 MG（67.6%）（p<0.001），与临床 MRI 无差异。DWI+TIRM 对乳腺癌的检出准确率（AUC=0.935）和敏感度（93.68%）均高于 MG（AUC=0.783，敏感度=46.32%），与临床 MRI 相当（AUC=0.944，敏感度=93.68%）。DWI+TIRM 的特异度（83.95%）低于 MG（98.77%），但高于临床 MRI（77.78%）。
DWI 联合 TIRM 可能是一种安全、敏感、实用的致密乳腺筛查方法。
