酰胺质子转移加权成像与体素内不相干运动成像在乳腺癌诊断及评估中的对比研究
Comparative Study of Amide Proton Transfer-Weighted Imaging and Intravoxel Incoherent Motion Imaging in Breast Cancer Diagnosis and Evaluation.
作者信息
Meng Nan, Wang Xue-Jia, Sun Jing, Huang Ling, Wang Zhe, Wang Kai-Yu, Wang Jing, Han Dong-Ming, Wang Mei-Yun
机构信息
Department of Radiology, Zhengzhou University People's Hospital & Henan Provincial People's Hospital, Zhengzhou, China.
Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China.
出版信息
J Magn Reson Imaging. 2020 Oct;52(4):1175-1186. doi: 10.1002/jmri.27190. Epub 2020 May 5.
BACKGROUND
Amide proton transfer-weighted imaging (APTWI) and intravoxel incoherent motion imaging (IVIM) are valuable MRI techniques applied to cancer.
PURPOSE
To compare APTWI and IVIM in the diagnosis of benign and malignant breast lesions and to evaluate the correlations between different parameters (MTRasym [3.5 ppm], D, D*, and f) and prognostic factors for breast cancer.
STUDY TYPE
Retrospective.
POPULATION
In all, 123 breast lesions were studied before treatment, including 58 benign lesions and 65 malignant lesions.
FIELD STRENGTH/SEQUENCE: Conventional MRI (T WI, T WI, and diffusion-weighted imaging [DWI]), APTWI, and IVIM MRI at 3T.
ASSESSMENT
The magnetization transfer ratio asymmetry at 3.5 ppm (MTRasym [3.5 ppm]), diffusion coefficient (D), pseudo diffusion coefficient (D*), and perfusion fraction (f) values were compared between the benign and malignant groups and between groups with different expression levels of prognostic factors.
STATISTICAL TESTS
Individual sample t-test, χ test, Spearman correlation, logistic regression, and the Delong test.
RESULTS
The D and MTRasym (3.5 ppm) values of the malignant group were lower than those of the benign group; however, D* and f values were higher than those of the benign group (all P < 0.05). The areas under the curve (AUCs) of D, MTRasym (3.5 ppm), D*, and f were 0.809, 0.778, 0.670, and 0.766, respectively; however, only the difference between AUC (D) and AUC (D*) was significant (Z = 2.374, P < 0.05). The D value showed a low correlation with the pathological grade and Ki-67 expression (| r | = 0.294, 0.367); the f value showed a low correlation with estrogen receptor (ER) expression (| r | = 0.382); and the MTRasym (3.5 ppm) value showed a low correlation with pathological grade (| r | = 0.371).
DATA CONCLUSION
This analysis revealed that both IVIM and APTWI could be used for the differential diagnosis of benign and malignant breast lesions, and APTWI-derived MTRasym (3.5 ppm), IVIM-derived D, D*, and f values showed correlations with some prognostic factors for breast cancer.
LEVEL OF EVIDENCE
2 TECHNICAL EFFICACY STAGE: 2 J. Magn. Reson. Imaging 2020;52:1175-1186.
背景
酰胺质子转移加权成像（APTWI）和体素内不相干运动成像（IVIM）是应用于癌症的有价值的MRI技术。
目的
比较APTWI和IVIM在乳腺良恶性病变诊断中的应用，并评估不同参数（MTRasym[3.5 ppm]、D、D*和f）与乳腺癌预后因素之间的相关性。
研究类型
回顾性研究。
研究对象
共对123例乳腺病变进行了治疗前研究，其中包括58例良性病变和65例恶性病变。
场强/序列：3T下的常规MRI（T1WI、T2WI和扩散加权成像[DWI]）、APTWI和IVIM MRI。
评估
比较了良性和恶性组以及具有不同预后因素表达水平的组之间的3.5 ppm处的磁化传递率不对称性（MTRasym[3.5 ppm]）、扩散系数（D）、伪扩散系数（D*）和灌注分数（f）值。
统计检验
单样本t检验、χ检验、Spearman相关性分析、逻辑回归分析和德龙检验。
结果
恶性组的D值和MTRasym（3.5 ppm）值低于良性组；然而，D值和f值高于良性组（均P<0.05）。D、MTRasym（3.5 ppm）、D和f的曲线下面积（AUC）分别为0.809、0.778、0.670和0.766；然而，只有AUC（D）和AUC（D*）之间的差异具有统计学意义（Z = 2.374，P<0.05）。D值与病理分级和Ki-67表达呈低度相关（|r| = 0.294，0.367）；f值与雌激素受体（ER）表达呈低度相关（|r| = 0.382）；MTRasym（3.5 ppm）值与病理分级呈低度相关（|r| = 0.371）。
数据结论
该分析表明，IVIM和APTWI均可用于乳腺良恶性病变的鉴别诊断，并且APTWI衍生的MTRasym（3.5 ppm）、IVIM衍生的D、D*和f值与乳腺癌的一些预后因素相关。
证据水平
2级 技术效能阶段：2级 J.Magn.Reson.Imaging 2020；52：1175 - 1186。
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