Division of Radiology, 92293Sichuan Cancer Hospital and Research Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology, Chengdu 61004, Sichuan, PR China.
Acta Radiol. 2022 Apr;63(4):447-457. doi: 10.1177/02841851211002834. Epub 2021 Mar 27.
Non-invasive modalities for assessing axillary lymph node (ALN) are needed in clinical practice.
To investigate the suspicious ALN on unenhanced T2-weighted (T2W) imaging and intravoxel incoherent motion diffusion-weighted imaging (IVIM DWI) for predicting ALN metastases (ALNM) in patients with T1-T2 stage breast cancer and clinically negative ALN.
Two radiologists identified the most suspicious ALN or the largest ALN in negative axilla by T2W imaging features, including short axis (Size-S), long axis (Size-L)/S ratio, fatty hilum, margin, and signal intensity on T2W imaging. The IVIM parameters of these selected ALNs were also obtained. The Mann-Whitney U test or t-test was used to compare the metastatic and non-metastatic ALN groups. Finally, logistic regression analysis with T2W imaging and IVIM features for predicting ALNM was conducted.
This study included 49 patients with metastatic ALNs and 50 patients with non-metastatic ALNs. Using the above conventional features on T2W imaging, the sensitivity and specificity in predicting ALNM were not high. Compared with non-metastatic ALNs, metastatic ALNs had lower pseudo-diffusion coefficient (D*) ( = 0.043). Logistic regression analysis showed that the most useful features for predicting ALNM were signal intensity and D*. The sensitivity and specificity predicting ALNM that satisfied abnormal signal intensity and lower D* were 73.5% and 84%, respectively.
The abnormal signal intensity on T2W imaging and one IVIM feature (D*) were significantly associated with ALNM, with sensitivity of 73.5% and specificity of 84%.
在临床实践中，需要非侵入性方法来评估腋窝淋巴结 (ALN)。
研究 T1-T2 期乳腺癌且临床腋窝阴性患者中，在未增强 T2 加权 (T2W) 成像和体素内不相干运动扩散加权成像 (IVIM DWI) 上可疑 ALN 预测 ALN 转移 (ALNM) 的价值。
两名放射科医生根据 T2W 成像特征，包括短轴 (Size-S)、长轴 (Size-L)/S 比、脂肪门、边界和 T2W 成像上的信号强度，识别阴性腋窝中最可疑的 ALN 或最大的 ALN。还获得了这些选定的 ALN 的 IVIM 参数。使用 Mann-Whitney U 检验或 t 检验比较转移性和非转移性 ALN 组。最后，进行了 T2W 成像和 IVIM 特征的 logistic 回归分析，以预测 ALNM。
本研究共纳入 49 例转移性 ALN 患者和 50 例非转移性 ALN 患者。使用 T2W 成像上的上述常规特征，预测 ALNM 的敏感性和特异性不高。与非转移性 ALN 相比，转移性 ALN 的假性扩散系数 (D*) 较低 ( = 0.043)。逻辑回归分析表明，预测 ALNM 最有用的特征是信号强度和 D*。满足异常信号强度和较低 D*的预测 ALNM 的敏感性和特异性分别为 73.5%和 84%。
T2W 成像上的异常信号强度和一个 IVIM 特征 (D*) 与 ALNM 显著相关，敏感性为 73.5%，特异性为 84%。
