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使用压缩感知的超快动态对比增强 MRI:早期动力学参数与乳腺癌预后因素的相关性。

Ultrafast Dynamic Contrast-Enhanced MRI Using Compressed Sensing: Associations of Early Kinetic Parameters With Prognostic Factors of Breast Cancer.

机构信息

Department of Radiology, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, 1-10, Ami-Dong, Seo-gu, Busan 602-739, Republic of Korea.

Siemens Healthineers Ltd., Seoul, Korea.

出版信息

AJR Am J Roentgenol. 2021 Jul;217(1):56-63. doi: 10.2214/AJR.20.23457. Epub 2021 Apr 28.

Abstract

The purpose of this study was to investigate whether early kinetic parameters derived from ultrafast dynamic contrast-enhanced MRI (DCE-MRI) using compressed sensing are associated with prognostic factors for breast cancer. We evaluated 201 consecutive women (mean age, 54.6 years) with breast cancer (168 invasive, 33 ductal carcinoma in situ) who underwent both ultrafast DCE-MRI using compressed sensing (temporal resolution, 4.7 seconds; spatial resolution, 0.8 × 1.1 × 0.9 mm) and surgery between 2018 and 2019. Early kinetic parameters (time to enhancement [TTE] and maximum slope [MS]) were measured in breast lesions by two radiologists using a software program and were correlated with histopathologic prognostic factors. The Mann-Whitney test and linear regression analysis were used. The median TTE and MS values for breast cancer were 11.9 seconds and 7.7%/s, respectively. The median MS was significantly larger in invasive cancer lesions than in ductal carcinoma in situ lesions (8.4%/s vs 4.7%/s, < .001). In women with invasive cancer, multivariate linear regression analyses showed that a larger tumor size (> 2 cm) ( = .048) and estrogen receptor-negative status ( < .001) were significantly associated with a shorter TTE. A higher histologic grade (grade 3) ( = .01) was significantly associated with a larger MS. We observed excellent interobserver agreement between two readers in the measurements of TTE and MS (intraclass correlation coefficients, 0.943 and 0.890, respectively). Ultrafast MRI-derived early enhancement parameters, such as TTE and MS, are associated with histopathologic prognostic factors in women with breast cancer.

摘要

这项研究的目的是探究超快速动态对比增强磁共振成像(DCE-MRI)使用压缩感知技术获得的早期动力学参数是否与乳腺癌的预后因素相关。我们评估了 201 例连续的乳腺癌患者(平均年龄 54.6 岁),这些患者在 2018 年至 2019 年间均接受了超快速 DCE-MRI(时间分辨率为 4.7 秒,空间分辨率为 0.8×1.1×0.9mm)和手术。两位放射科医生使用软件程序在乳腺病变中测量早期动力学参数(增强时间[TTE]和最大斜率[MS]),并将其与组织病理学预后因素相关联。使用 Mann-Whitney U 检验和线性回归分析。乳腺癌的 TTE 和 MS 中位数分别为 11.9 秒和 7.7%/s。浸润性癌病变的 MS 中位数明显大于导管原位癌病变(8.4%/s 比 4.7%/s, <.001)。在浸润性癌患者中,多元线性回归分析显示,肿瘤较大(>2cm)( =.048)和雌激素受体阴性状态( <.001)与较短的 TTE 显著相关。较高的组织学分级(3 级)( =.01)与较大的 MS 显著相关。我们观察到两位读者在 TTE 和 MS 测量方面具有极好的观察者间一致性(组内相关系数分别为 0.943 和 0.890)。乳腺癌患者的超快速 MRI 衍生早期增强参数,如 TTE 和 MS,与组织病理学预后因素相关。

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