同步性乳腺癌：MRI上的表型相似性

Synchronous Breast Cancer: Phenotypic Similarities on MRI.

作者信息

Wang Hui, van der Velden Bas H M, Chan Hui Shan M, Loo Claudette E, Viergever Max A, Gilhuijs Kenneth G A

机构信息

Image Sciences Institute, University Medical Center Utrecht, Utrecht, Netherlands.

Department of Radiology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands.

出版信息

J Magn Reson Imaging. 2020 Jun;51(6):1858-1867. doi: 10.1002/jmri.27026. Epub 2019 Dec 19.

DOI:10.1002/jmri.27026

PMID:31854487

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7318126/

Abstract

BACKGROUND

Previous studies have shown discrepancies between index and synchronous breast cancer in histology and molecular phenotype. It is yet unknown whether this observation also applies to the MRI phenotype.

PURPOSE

To investigate whether the appearance of breast cancer on MRI (i.e. phenotype) is different from that of additional breast cancer (i.e. synchronous cancer), and whether such a difference, if it exists, is associated with prognosis.

STUDY TYPE

Retrospective.

POPULATION

In all, 464 consecutive patients with early-stage ER+/HER2- breast cancer were included; 34/464 (7.3%) had 44 synchronous cancers in total (34 ipsilateral, 10 contralateral).

SEQUENCE

1.5T, contrast-enhanced T -weighted.

ASSESSMENT

We assessed imaging phenotype using 50 quantitative features from each cancer and applied principal component analysis (PCA) to identify independent properties. The degree of phenotype difference was assessed. An association between phenotype differences and prognosis in terms of the Nottingham Prognostic Index (NPI) and PREDICT score were analyzed.

STATISTICAL TESTS

PCA; Wilcoxon rank sum test; Benjamini-Hochberg to control the false discovery rate.

RESULTS

PCA identified eight components in patients with ipsilateral synchronous cancer. Six out of eight were significantly different between index and synchronous cancer. These components represented features describing texture (three components, P < 0.001, P < 0.001, P = 0.004), size (P < 0.001), smoothness (P < 0.001), and kinetics (P = 0.004). Phenotype differences in terms of the six components were split in tertiles. Larger phenotype differences in size, kinetics, and texture were associated with significantly worse prognosis in terms of NPI (P = 0.019, P = 0.045, P = 0.014), but not for the PREDICT score (P = 0.109, P = 0.479, P = 0.109). PCA identified six components in patients with contralateral synchronous cancer. None were significantly different from the index cancer (P = 0.178, P = 0.178, P = 0.178, P = 0.326, P = 0.739, P = 0.423).

DATA CONCLUSION

The MRI phenotype of ER+/HER2- breast cancer was different from that of ipsilateral synchronous cancer and a large phenotype difference was associated with worse prognosis. No significant difference was found for synchronous contralateral cancer.

LEVEL OF EVIDENCE

3 Technical Efficacy: Stage 4 J. Magn. Reson. Imaging 2020;51:1858-1867.

摘要

背景

先前的研究表明，原发性乳腺癌与同期乳腺癌在组织学和分子表型上存在差异。目前尚不清楚这一观察结果是否也适用于MRI表型。

目的

研究乳腺癌在MRI上的表现（即表型）是否与其他乳腺癌（即同期癌）不同，以及这种差异（如果存在）是否与预后相关。

研究类型

回顾性研究。

研究对象

总共纳入了464例连续的早期ER+/HER2-乳腺癌患者；其中34/464（7.3%）共患有44例同期癌（34例同侧，10例对侧）。

序列

1.5T，对比增强T加权成像。

评估

我们使用来自每个癌症的50个定量特征评估成像表型，并应用主成分分析（PCA）来识别独立特征。评估表型差异程度。分析表型差异与诺丁汉预后指数（NPI）和预测评分所反映的预后之间的关联。

统计检验

PCA；Wilcoxon秩和检验；Benjamini-Hochberg方法控制错误发现率。

结果

PCA在同侧同期癌患者中识别出八个成分。其中八个中的六个在原发性癌和同期癌之间存在显著差异。这些成分代表了描述纹理（三个成分，P < 0.001，P < 0.001，P = 0.004）、大小（P < 0.001）、平滑度（P < 0.001）和动力学（P = 0.004）的特征。六个成分方面的表型差异分为三分位数。在大小、动力学和纹理方面较大的表型差异与NPI所反映的预后显著较差相关（P = 0.019，P = 0.045，P = 0.014），但与预测评分无关（P = 0.109，P = 0.479，P = 0.109）。PCA在对侧同期癌患者中识别出六个成分。没有一个与原发性癌有显著差异（P = 0.178，P = 0.178，P = 0.178，P = 0.326，P = 0.739，P = 0.423）。