Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine.
Department of Diagnostic Radiology, Kansai Electric Power Hospital.
Magn Reson Med Sci. 2023 Oct 1;22(4):469-476. doi: 10.2463/mrms.mp.2022-0060. Epub 2022 Aug 3.
To investigate whether intravoxel incoherent motion (IVIM) and/or non-Gaussian diffusion parameters are associated with distant disease-free survival (DDFS) in patients with invasive breast cancer.
From May 2013 to March 2015, 101 patients (mean age 60.0, range 28-88) with invasive breast cancer were evaluated prospectively. IVIM parameters (flowing blood volume fraction [f] and pseudodiffusion coefficient [D*]) and non-Gaussian diffusion parameters (theoretical apparent diffusion coefficient [ADC] at a b value of 0 s/mm [ADC] and kurtosis [K]) were estimated using a diffusion-weighted imaging series of 16 b values up to 2500 s/mm. Shifted ADC values (sADC) and standard ADC values (ADC) were also calculated. The Kaplan-Meier method was used to generate survival analyses for DDFS, which were compared using the log-rank test. Univariable Cox proportional hazards models were used to assess any associations between each parameter and distant metastasis-free survival.
The median observation period was 80 months (range, 35-92 months). Among the 101 patients, 12 (11.9%) developed distant metastasis, with a median time to metastasis of 79 months (range, 10-92 months). Kaplan-Meier analysis showed that DDFS was significantly shorter in patients with K > 0.98 than in those with K ≤ 0.98 (P = 0.04). Cox regression analysis showed a marginal statistical association between K and distant metastasis-free survival (P = 0.05).
Non-Gaussian diffusion may be associated with prognosis in invasive breast cancer. A higher K may be a marker to help identify patients at an elevated risk of distant metastasis, which could guide subsequent treatment.
研究体素内不相干运动（IVIM）和/或非高斯扩散参数与浸润性乳腺癌患者无远处疾病生存（DDFS）的关系。
2013 年 5 月至 2015 年 3 月，前瞻性评估了 101 例浸润性乳腺癌患者（平均年龄 60.0 岁，范围 28-88 岁）。使用 16 个 b 值（0 s/mm2 至 2500 s/mm2）的扩散加权成像序列估计 IVIM 参数（血流分数 [f]和假性扩散系数 [D*]）和非高斯扩散参数（理论表观扩散系数 [ADC]在 b 值为 0 s/mm2时[ADC]和峰度 [K]）。还计算了移位 ADC 值（sADC）和标准 ADC 值（ADC）。Kaplan-Meier 法用于生成 DDFS 的生存分析，并使用对数秩检验进行比较。单变量 Cox 比例风险模型用于评估每个参数与无远处转移生存之间的任何关联。
中位观察期为 80 个月（范围 35-92 个月）。在 101 例患者中，12 例（11.9%）发生远处转移，中位转移时间为 79 个月（范围 10-92 个月）。Kaplan-Meier 分析显示，K 值>0.98 的患者的 DDFS 明显短于 K 值≤0.98 的患者（P=0.04）。Cox 回归分析显示 K 与无远处转移生存之间存在边缘统计学关联（P=0.05）。
非高斯扩散可能与浸润性乳腺癌的预后相关。较高的 K 值可能是识别远处转移风险较高的患者的标志物，有助于指导后续治疗。
