利用高分辨率3D径向狄克逊磁共振成像获取的脂肪分数预测乳腺癌患者腋窝转移性淋巴结
Fat fractions from high-resolution 3D radial Dixon MRI for predicting metastatic axillary lymph nodes in breast cancer patients.
作者信息
Buus Thomas Winther, Sivesgaard Kim, Fris Tanja Linde, Christiansen Peer Michael, Jensen Anders Bonde, Pedersen Erik Morre
机构信息
Department of Radiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
Department of Plastic and Breast Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 35, 8200, Aarhus N, Denmark.
出版信息
Eur J Radiol Open. 2020 Nov 7;7:100284. doi: 10.1016/j.ejro.2020.100284. eCollection 2020.
PURPOSE
To assess diagnostic performance of fat fractions (FF) from high-resolution 3D radial Dixon MRI for differentiating metastatic and non-metastatic axillary lymph nodes in breast cancer patients.
METHOD
High-resolution 3D radial Dixon MRI was prospectively performed on 1.5 T in 70 biopsy-verified breast cancer patients. 35 patients were available for analysis with histopathologic and imaging data. FF images were calculated as fat / in-phase. Two radiologists measured lymph node FF and assessed morphological features in one ipsilateral and one contralateral lymph node in consensus. Diagnostic performance of lymph node FF and morphological criteria were compared using histopathology as reference.
RESULTS
22 patients had metastatic axillary lymph nodes. Mean lymph node FF were 0.20 ± 0.073, 0.31 ± 0.079, and 0.34 ± 0.15 (metastatic, non-metastatic ipsi- and non-metastatic contralateral lymph nodes, respectively). Metastatic lymph node FF were significantly lower than non-metastatic ipsi- ( < 0.001) and contralateral lymph nodes ( < 0.001). Area under the receiver operating characteristics curve for lymph node FF was 0.80 compared to 0.76 for morphological criteria ( = 0.29). Lymph node FF yielded sensitivity 0.91, specificity 0.69, positive predictive value (PPV) 0.83, and negative predictive value (NPV) 0.82, while morphological criteria yielded sensitivity 0.91, specificity 0.62, PPV 0.80, and NPV 0.80 ( = 0.71). Combining lymph node FF and morphological criteria increased diagnostic performance with sensitivity 1.00, specificity 0.67, PPV 0.86, NPV 1.00, and AUC 0.83.
CONCLUSIONS
Lymph node FF from high-resolution 3D Dixon images are a promising quantitative indicator of metastases in axillary lymph nodes.
目的
评估高分辨率三维径向狄克逊磁共振成像（MRI）测量的脂肪分数（FF）对乳腺癌患者腋窝转移性和非转移性淋巴结的诊断效能。
方法
对70例经活检证实的乳腺癌患者在1.5T磁共振成像设备上进行前瞻性高分辨率三维径向狄克逊MRI检查。35例患者的组织病理学和影像学数据可用于分析。FF图像通过脂肪/同相位计算得出。两名放射科医生共同测量淋巴结FF，并评估一侧同侧和一侧对侧淋巴结的形态特征。以组织病理学为参考，比较淋巴结FF和形态学标准的诊断效能。
结果
22例患者有腋窝转移性淋巴结。转移性、非转移性同侧和非转移性对侧淋巴结的平均淋巴结FF分别为0.20±0.073、0.31±0.079和0.34±0.15。转移性淋巴结的FF显著低于非转移性同侧（<0.001）和对侧淋巴结（<0.001）。淋巴结FF的受试者工作特征曲线下面积为0.80，而形态学标准为0.76（P=0.29）。淋巴结FF的敏感性为0.91，特异性为0.69，阳性预测值（PPV）为0.83，阴性预测值（NPV）为0.82，而形态学标准的敏感性为0.91，特异性为0.62，PPV为0.80，NPV为0.80（P=0.71）。结合淋巴结FF和形态学标准可提高诊断效能，敏感性为1.00，特异性为0.67,PPV为0.86，NPV为1.00，曲线下面积为0.83。
结论
高分辨率三维狄克逊图像中的淋巴结FF是腋窝淋巴结转移的一个有前景的定量指标。
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