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在标准磁共振成像(MRI)上,表观扩散系数图直方图分析在鉴别三阴性乳腺癌与其他亚型乳腺癌中的附加价值。

Added value of histogram analysis of apparent diffusion coefficient maps for differentiating triple-negative breast cancer from other subtypes of breast cancer on standard MRI.

作者信息

Liu Hong-Li, Zong Min, Wei Han, Wang Cong, Lou Jian-Juan, Wang Si-Qi, Zou Qi-Gui, Jiang Yan-Ni

机构信息

Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People's Republic of China.

Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People's Republic of China.

出版信息

Cancer Manag Res. 2019 Sep 6;11:8239-8247. doi: 10.2147/CMAR.S210583. eCollection 2019.


DOI:10.2147/CMAR.S210583
PMID:31564982
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6735623/
Abstract

BACKGROUND: Triple-negative breast cancers generally occur in young women with remarkable potential to be aggressive. It will be of great help to detect this subtype of tumor early. To retrospectively evaluate the performance of histogram analysis of apparent diffusion coefficient (ADC) maps in distinguishing triple-negative breast cancer (TNBC) from other subtypes of breast cancer (non-TNBC), when combined with magnetic resonance imaging (MRI) features. MATERIALS AND METHODS: From February 2014 to December 2018, 192 patients were included in this study taking preoperative standard MRI (s-MRI) and DWI. Seventy-six of them were pathologically confirmed with TNBC and rest 116 with other subtypes. First, their clinical-pathological features and morphological characteristics on MRI were assessed, including tumor size, foci quantity, tumor shape, margin, internal enhancement, and time-signal intensity curve types, in addition to the signal intensity on T2-weighted images. Second, whole-lesion apparent diffusion coefficient (ADC) histogram analysis was executed. Finally, both univariate and multivariate regression analyses were applied to identify the most useful variables in separating TNBCs from non-TNBCs, and then their effects were evaluated following receiver operating characteristic curve analysis. RESULT: Multivariate regression analysis indicated that circumscribed margin, rim enhancement, and ADC were important predictors for TNBC. Increased area under curve (AUC) and improved specificity can be obtained when combined s-MRI and DWI (circumscribed margin+rim enhancement+ADC>1.47×10 mm/s) is taken as the criterion, other than s-MRI (circumscribed margin+rim enhancement) alone (s-MRI+DWI vs s-MRI; AUC, 0.833 vs 0.797; specificity, 98.3% vs 89.7%; sensitivity, 68.4% vs 69.7%). CONCLUSION: Circumscribed margin and rim enhancement on s-MRI and ADC are three important elements in detecting TNBC, while ADC histogram analysis can provide additional value in this detection.

摘要

背景:三阴性乳腺癌通常发生在年轻女性中,具有显著的侵袭性。早期检测这种肿瘤亚型将有很大帮助。为了回顾性评估表观扩散系数(ADC)图的直方图分析在结合磁共振成像(MRI)特征时区分三阴性乳腺癌(TNBC)与其他亚型乳腺癌(非TNBC)的性能。 材料与方法:2014年2月至2018年12月,本研究纳入192例术前行标准MRI(s-MRI)和DWI检查的患者。其中76例经病理证实为TNBC,其余116例为其他亚型。首先,评估其临床病理特征和MRI上的形态学特征,包括肿瘤大小、病灶数量、肿瘤形状、边缘、内部强化、时间-信号强度曲线类型,以及T2加权图像上的信号强度。其次,进行全病灶表观扩散系数(ADC)直方图分析。最后,应用单变量和多变量回归分析来确定区分TNBC和非TNBC最有用的变量,然后通过受试者操作特征曲线分析评估其效果。 结果:多变量回归分析表明,边界清晰、边缘强化和ADC是TNBC的重要预测指标。当以联合s-MRI和DWI(边界清晰+边缘强化+ADC>1.47×10 mm/s)为标准时,曲线下面积(AUC)增加且特异性提高,而不是单独使用s-MRI(边界清晰+边缘强化)(s-MRI+DWI与s-MRI比较;AUC,0.833对0.797;特异性,98.3%对89.7%;敏感性,68.4%对69.7%)。 结论:s-MRI上的边界清晰和边缘强化以及ADC是检测TNBC的三个重要因素,而ADC直方图分析在该检测中可提供额外价值。

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本文引用的文献

[1]
Impact of histopathology, tumor-infiltrating lymphocytes, and adjuvant chemotherapy on prognosis of triple-negative breast cancer.

Breast Cancer Res Treat. 2017-9-14

[2]
Preoperative predicting malignancy in breast mass-like lesions: value of adding histogram analysis of apparent diffusion coefficient maps to dynamic contrast-enhanced magnetic resonance imaging for improving confidence level.

Br J Radiol. 2017-11

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Novel immunohistochemistry-based signatures to predict metastatic site of triple-negative breast cancers.

Br J Cancer. 2017-9-5

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Cancer Med. 2017-3

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Br J Radiol. 2016-12

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Eur Radiol. 2016-12

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Radiology. 2016-9

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J Magn Reson Imaging. 2016-7

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Characterization of breast masses as benign or malignant at 3.0T MRI with whole-lesion histogram analysis of the apparent diffusion coefficient.

J Magn Reson Imaging. 2016-4

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