Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Radiology, Seoul National College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea.
Eur Radiol. 2020 Jul;30(7):4058-4068. doi: 10.1007/s00330-020-06693-0. Epub 2020 Mar 6.
This study was conducted in order to investigate whether there is a correlation between the time-to-enhancement (TTE) in ultrafast MRI and histopathological characteristics of breast cancers.
Between January and August 2017, 274 consecutive breast cancer patients (mean age, 53.5 years; range, 25-80 years) who underwent ultrafast MRI and subsequent surgery were included for analysis. Ultrafast MRI scans were acquired using TWIST-VIBE or 4D TRAK-3D TFE sequences. TTE and maximum slope (MS) were derived from the ultrafast MRI. The repeated measures ANOVA, Mann-Whitney U test and Kruskal-Wallis H test were performed to compare the median TTE, MS and SER according to histologic type, histologic grade, ER/PR/HER2 positivity, level of Ki-67 and tumour subtype. For TTE calculation, intraclass correlation coefficient (ICC) was used to evaluate interobserver variability.
The median TTE of invasive cancers was shorter than that of in situ cancers (p < 0.001). In invasive cancers, large tumours showed shorter TTE than small tumours (p = 0.001). High histologic/nuclear grade cancers had shorter TTE than low to intermediate grade cancers (p < 0.001 and p < 0.001). HER2-positive cancers showed shorter TTE than HER2-negative cancers (p = 0.001). The median TTE of cancers with high Ki-67 was shorter than that of cancers with low Ki-67 (p < 0.001). ICC between two readers showed moderate agreement (0.516). No difference was found in the median MS or SER values according to the clinicopathologic features.
The median TTE of breast cancer in ultrafast MRI was shorter in invasive or aggressive tumours than in in situ cancer or less aggressive tumours, respectively.
• Invasive breast tumours show a shorter TTE in ultrafast DCE-MRI than in situ cancers. • A shorter TTE in ultrafast DCE-MRI is associated with breast tumours of a large size, high histologic or nuclear grade, PR negativity, HER2 positivity and high Ki-67 level.
本研究旨在探讨超快速 MRI 中的增强时间（TTE）与乳腺癌组织病理学特征之间是否存在相关性。
2017 年 1 月至 8 月，纳入了 274 例连续接受超快速 MRI 检查和后续手术的乳腺癌患者（平均年龄 53.5 岁；范围 25-80 岁）进行分析。超快速 MRI 扫描采用 TWIST-VIBE 或 4D TRAK-3D TFE 序列采集。从超快速 MRI 中得出 TTE 和最大斜率（MS）。采用重复测量方差分析、Mann-Whitney U 检验和 Kruskal-Wallis H 检验比较组织学类型、组织学分级、ER/PR/HER2 阳性、Ki-67 水平和肿瘤亚型的中位 TTE、MS 和 SER。对于 TTE 计算，采用组内相关系数（ICC）评估观察者间的变异性。
浸润性癌的中位 TTE 短于原位癌（p<0.001）。在浸润性癌中，大肿瘤的 TTE 短于小肿瘤（p=0.001）。高组织学/核分级的癌症 TTE 短于低至中分级的癌症（p<0.001 和 p<0.001）。HER2 阳性癌症的 TTE 短于 HER2 阴性癌症（p=0.001）。高 Ki-67 水平的癌症中位 TTE 短于低 Ki-67 水平的癌症（p<0.001）。两位观察者的 ICC 显示出中等一致性（0.516）。根据临床病理特征，中位 MS 或 SER 值无差异。
超快速 MRI 中乳腺癌的中位 TTE 在侵袭性或侵袭性肿瘤中短于原位癌或侵袭性较低的肿瘤。
超快速 DCE-MRI 中的浸润性乳腺癌 TTE 短于原位癌。
超快速 DCE-MRI 中的短 TTE 与肿瘤较大、组织学或核分级较高、PR 阴性、HER2 阳性和 Ki-67 水平较高相关。
