不同时间点 DCE-MRI 参数的差异及其对乳腺癌腋窝淋巴结转移的预测价值。
Difference of DCE-MRI Parameters at Different Time Points and Their Predictive Value for Axillary Lymph Node Metastasis of Breast Cancer.
机构信息
The First Clinical Medical College of Lanzhou University, Lanzhou 730000, China; Department of Radiology, the First Hospital of Lanzhou University, Lanzhou 730000, China.
Department of Radiology, the First Hospital of Lanzhou University, Lanzhou 730000, China.
出版信息
Acad Radiol. 2022 Jan;29 Suppl 1:S79-S86. doi: 10.1016/j.acra.2021.01.013. Epub 2021 Jan 25.
RATIONALE AND OBJECTIVES
To assess differences of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) parameters at different postcontrast time points (TPs), and to explore the predictive value of DCE-MRI parameters for axillary lymph node (ALN) metastasis of breast cancer.
MATERIALS AND METHODS
A total of 107 breast cancer patients were included retrospectively, and 50 phases were collected on DCE-MRI for each patient. DCE-MRI parameters Ktrans, Kep, Ve, TTP, Peak, Washin, Washout, and AUC were extracted from the images at 67.8 seconds, 128.5 seconds, 189.2 seconds, 249.9 seconds, and 310.5 seconds (regard as TP1, 2, 3, 4, and 5). Wilcoxon signed rank test was used to compare DCE-MRI parameters at different postcontrast TPs. Logistic regression was performed to analyze the predictive value of DCE-MRI parameters for ALN metastasis of breast cancer, and receiver operating characteristic (ROC) curve was constructed to evaluate the predictive performance.
RESULTS
The difference of DCE-MRI parameters between TP1, 2, 3, 4, and 5 was statistically significant (p < 0.01) in breast cancer. The TPs are considered as the optimal TPs when DCE-MRI parameters values reach the maximum. The optimal TPs of Ktrans, Kep, and Ve were respectively at TP2, TP2, and TP4 (Ktrans, Kep, and Ve). The optimal TPs of TTP, Peak, and AUC were at TP5 (TTP, Peak, and AUC). AUC showed the ability to predict ALN metastasis of breast cancer (area under ROC curve = 0.656, p < 0.05).
CONCLUSIONS
DCE-MRI parameters values were different at different postcontrast TPs. AUC may be an independent predictor of ALN metastasis in breast cancer.
背景与目的
评估不同对比后时间点（TP）的动态对比增强磁共振成像（DCE-MRI）参数的差异，并探讨 DCE-MRI 参数对乳腺癌腋窝淋巴结（ALN）转移的预测价值。
材料与方法
回顾性纳入 107 例乳腺癌患者，每位患者采集 50 个 DCE-MRI 相位。从图像中提取 67.8 秒、128.5 秒、189.2 秒、249.9 秒和 310.5 秒（分别视为 TP1、2、3、4 和 5）的 DCE-MRI 参数 Ktrans、Kep、Ve、TTP、Peak、Washin、Washout 和 AUC。采用 Wilcoxon 符号秩检验比较不同对比后 TP 的 DCE-MRI 参数。采用 Logistic 回归分析 DCE-MRI 参数对乳腺癌 ALN 转移的预测价值，并构建受试者工作特征（ROC）曲线评估预测性能。
结果
乳腺癌患者 DCE-MRI 参数在 TP1、2、3、4 和 5 之间存在统计学差异（p < 0.01）。当 DCE-MRI 参数值达到最大值时，这些 TP 被认为是最佳 TP。Ktrans、Kep 和 Ve 的最佳 TP 分别为 TP2、TP2 和 TP4（Ktrans、Kep 和 Ve）。TTP、Peak 和 AUC 的最佳 TP 为 TP5（TTP、Peak 和 AUC）。AUC 显示出预测乳腺癌 ALN 转移的能力（ROC 曲线下面积=0.656，p < 0.05）。
结论
不同对比后 TP 的 DCE-MRI 参数值存在差异。AUC 可能是乳腺癌 ALN 转移的独立预测因子。
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