新辅助化疗中浸润性导管乳腺癌的肿瘤纹理参数：乳腺 MRI 上早期识别无应答者。

Tumor texture parameters of invasive ductal breast carcinoma in neoadjuvant chemotherapy: early identification of non-responders on breast MRI.

机构信息

Institute of Oncology and Radiology of Serbia, Clinic for Radiology and Radiation Oncology, Dept. of Radiology, Dept. of Breast Imaging, School of Medicine, University of Belgrade, Belgrade, Serbia.

出版信息

Clin Imaging. 2020 Sep;65:119-123. doi: 10.1016/j.clinimag.2020.04.016. Epub 2020 Apr 21.

DOI:10.1016/j.clinimag.2020.04.016

PMID:32446129

Abstract

PURPOSE

Texture analysis (TA) parameters (variance of SI, mean of gradient, variance of gradient, kurtosis of SI, and entropy) in patients with invasive ductal carcinoma (IDC) contribute to objective assessment of neoadjuvant chemotherapy (NACT) activity. The objective was to assess TA parameters in early identification of non-responders (NR) in NACT, after the 2nd cycle of NACT.

MATERIAL AND METHODS

Fifty patients (N = 50) were included in the retrospective analysis of baseline and MRI following the 2nd cycle of NACT. TA parameters were computed and correlated to the lesion size and DWI-ADC in NR (N1 = 25). Additional matched responders (R, N2 = 25) assessed for the same parameters, served as the control group.

RESULTS

Tumor size and ADC did not change significantly in NR after the 2nd cycle of NACT (2.88 ± 0.38 vs. 2.76 ± 0.36 [cm], p = 0.131; 1.01 ± 0.14 vs. 1.05 ± 0.13 [mm/s × 10], p = 0.363), but TA parameters changed significantly: variance of gradient (346.5 ± 12.6 vs. 355.6 ± 16.9, p = 0.01), kurtosis of SI (1.47 ± 0.09 vs. 1.54 ± 0.11, p = 0.02), entropy LH (60.39 ± 4.34 vs. 64.42 ± 3.05, p = 0.001) and entropy HL (61.02 ± 5.51 vs. 65.63 ± 3.63, p < 0.00001). TA parameters, particularly entropy (EN LH 64.42 ± 3.05 vs. 61.59 ± 1.76, p < 0.0001; EN HL 65.63 ± 3.63 vs. 62.89 ± 2.05, p < 0.0001), significantly differ between NR and R in early response assessment.

CONCLUSION

Entropy, kurtosis of SI and variance of gradient tend to increase in NR. TA parameters significantly differ between NR and R after the 2nd cycle of NACT. TA parameters, related to morpho-functional parameters may contribute to early NR identification.

摘要

目的

在接受新辅助化疗（NACT）的患者中，纹理分析（TA）参数（SI 的方差、梯度的均值、梯度的方差、SI 的峰度和熵）有助于对 NACT 活性进行客观评估。本研究旨在评估 TA 参数在 NACT 第 2 周期后早期识别无反应者（NR）中的作用。

材料和方法

回顾性分析了 50 例基线和 NACT 第 2 周期后 MRI 的患者（N=50）。计算 TA 参数，并与 NR（N1=25）的病变大小和 DWI-ADC 相关。另外，对 25 例匹配的反应者（R）评估了相同的参数，作为对照组。

结果

NR 患者在 NACT 第 2 周期后肿瘤大小和 ADC 无明显变化（2.88±0.38 对比 2.76±0.36 [cm]，p=0.131；1.01±0.14 对比 1.05±0.13 [mm/s×10]，p=0.363），但 TA 参数明显变化：梯度方差（346.5±12.6 对比 355.6±16.9，p=0.01）、SI 峰度（1.47±0.09 对比 1.54±0.11，p=0.02）、LH 熵（60.39±4.34 对比 64.42±3.05，p=0.001）和 HL 熵（61.02±5.51 对比 65.63±3.63，p<0.00001）。TA 参数，特别是熵（EN LH 64.42±3.05 对比 61.59±1.76，p<0.0001；EN HL 65.63±3.63 对比 62.89±2.05，p<0.0001），在早期反应评估中 NR 和 R 之间差异显著。