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体素内不相干运动磁共振成像在乳腺癌中的应用:与分子亚型和组织学分级的比较。

Intravoxel incoherent motion magnetic resonance imaging for breast cancer: A comparison with molecular subtypes and histological grades.

机构信息

Department of Radiology, School of Medicine, Kocaeli University, Kocaeli, Turkey.

Pfizer, Istanbul, Turkey.

出版信息

Magn Reson Imaging. 2021 May;78:35-41. doi: 10.1016/j.mri.2021.02.005. Epub 2021 Feb 6.

Abstract

PURPOSE

The purpose of this paper is to investigate whether the IVIM parameters (D, D *, f) helps to determine the molecular subtypes and histological grades of breast cancer.

METHODS

Fifty-one patients with breast cancer were included in the study. All subjects were examined by 3 T Magnetic Resonance Imaging (MRI). Diffusion-weighted imaging (DWI) was undertaken with 16 b-values. IVIM parameters [D (true diffusion coefficient), D* (pseudo-diffusion coefficient), f (perfusion fraction)] were calculated. Histopathological reports were reviewed to histological grade, histological type, and immunohistochemistry. IVIM parameters of tumors with different histological grades and molecular subtypes were compared.

RESULTS

D* and f were significantly different between molecular subtypes (p = 0.019, p = 0.03 respectively). D* and f were higher in the HER-2 group and lower in Triple negative (-) group (D*:36.8 × 10 ± 5.3 × 10 mm/s, f:29.5%, D*:29.8 × 10 ± 5.6 × 10 mm/s, f:21.5% respectively). There was a significant difference in D* and f between HER-2 and Triple (-) subgroups (p = 0,028, p = 0.024, respectively). D* was also significantly different between the HER-2 group and the Luminal group (p = 0,041). While histological grades increase, D and f values tend to decrease, and D* tends to increase. While the Ki-67 index increases, D* and f values tend to increase, and D tend to decrease.

CONCLUSION

D* and f values measured with IVIM imaging were useful for assessing breast cancer molecular subtyping. IVIM imaging may be an alternative to breast biopsy for sub-typing of breast cancer with further research.

摘要

目的

本文旨在探讨 IVIM 参数(D、D*、f)是否有助于确定乳腺癌的分子亚型和组织学分级。

方法

本研究纳入了 51 例乳腺癌患者。所有患者均接受 3T 磁共振成像(MRI)检查。采用 16 个 b 值进行扩散加权成像(DWI)。计算 IVIM 参数[D(真实扩散系数)、D*(假性扩散系数)、f(灌注分数)]。回顾组织病理学报告以确定组织学分级、组织学类型和免疫组织化学。比较不同组织学分级和分子亚型肿瘤的 IVIM 参数。

结果

分子亚型之间 D和 f 差异有统计学意义(p=0.019,p=0.03)。HER-2 组 D和 f 较高,三阴性(-)组较低(D*:36.8×10±5.3×10mm/s,f:29.5%,D*:29.8×10±5.6×10mm/s,f:21.5%)。HER-2 组和三阴性(-)亚组之间 D和 f 差异有统计学意义(p=0.028,p=0.024)。D在 HER-2 组和管腔组之间也有显著差异(p=0.041)。随着组织学分级的增加,D 和 f 值趋于降低,而 D趋于升高。随着 Ki-67 指数的增加,D和 f 值趋于升高,而 D 趋于降低。

结论

IVIM 成像测量的 D*和 f 值有助于评估乳腺癌的分子分型。IVIM 成像可能是替代乳腺癌活检进行乳腺癌亚型分类的一种方法,需要进一步研究。

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