Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan.
Department of Quantum Medical Imaging, Kanazawa University Graduate School of Medical Sciences, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8640, Japan.
Jpn J Radiol. 2022 Dec;40(12):1272-1281. doi: 10.1007/s11604-022-01316-8. Epub 2022 Jul 25.
To evaluate the similarity of quantitative dual-energy computed tomography (DECT) parameters between the primary breast cancer lesion and axillary lymph node (LN) for predicting LN metastasis.
This retrospective study included patients with breast cancer who underwent contrast-enhanced DECT between July 2019 and April 2021. Relationships between LN metastasis and simple DECT parameters, similarity of DECT parameters, and pathological and morphological features were analyzed. ROC curve analysis was used to evaluate diagnostic ability.
Overall, 137 LNs (39 metastases and 98 non-metastases) were evaluated. Significant differences were observed in some pathological (nuclear grade, estrogen receptor status, and Ki67 index) and morphological characteristics (shortest and longest diameters of the LN, longest-to-shortest diameter ratio, and hilum), most simple DECT parameters, and all DECT similarity parameters between the LN metastasis and non-metastasis groups (all, P < 0.001-0.004). The shortest diameter of the LN (odds ratio 2.22; 95% confidence interval 1.47, 3.35; P < 0.001) and the similarity parameter of 40-keV attenuation (odds ratio, 2.00; 95% confidence interval 1.13, 3.53; P = 0.017) were independently associated with LN metastasis compared to simple DECT parameters of 40-keV attenuation (odds ratio 1.01; 95% confidence interval 0.99, 1.03; P =0.35). The AUC value of the similarity parameters for predicting metastatic LN was 0.78-0.81, even in cohorts with small LNs (shortest diameter < 5 mm) (AUC value 0.73-0.78).
The similarity of the delayed-phase DECT parameters could be a more useful tool for predicting LN metastasis than simple DECT parameters in breast cancer, regardless of LN size.
评估原发性乳腺癌病变和腋窝淋巴结（LN）之间定量双能 CT（DECT）参数的相似性，以预测 LN 转移。
本回顾性研究纳入了 2019 年 7 月至 2021 年 4 月期间接受对比增强 DECT 的乳腺癌患者。分析了 LN 转移与简单 DECT 参数、DECT 参数相似性以及病理和形态特征之间的关系。使用 ROC 曲线分析评估诊断能力。
共评估了 137 个 LN（39 个转移和 98 个非转移）。LN 转移和非转移组之间在一些病理（核分级、雌激素受体状态和 Ki67 指数）和形态特征（LN 的最短和最长直径、最长与最短直径比以及门）、大多数简单 DECT 参数以及所有 DECT 相似性参数方面存在显著差异（均，P < 0.001-0.004）。LN 的最短直径（优势比 2.22；95%置信区间 1.47-3.35；P < 0.001）和 40keV 衰减的相似性参数（优势比，2.00；95%置信区间 1.13-3.53；P = 0.017）与简单的 40keV 衰减 DECT 参数（优势比 1.01；95%置信区间 0.99-1.03；P = 0.35）相比，与 LN 转移独立相关。预测转移性 LN 的相似性参数的 AUC 值为 0.78-0.81，即使在 LN 较小（最短直径 < 5mm）的队列中（AUC 值为 0.73-0.78）也是如此。
在乳腺癌中，与简单的 DECT 参数相比，延迟期 DECT 参数的相似性可能是预测 LN 转移的更有用工具，而与 LN 大小无关。
