基于视野优化和约束无扭曲单次激发（FOCUS）DWI 的全病变直方图分析在预测早期乳腺癌腋窝淋巴结状态中的价值。
The value of whole-lesion histogram analysis based on field‑of‑view optimized and constrained undistorted single shot (FOCUS) DWI for predicting axillary lymph node status in early-stage breast cancer.
机构信息
Department of Radiology, Changzhou Hospital of Traditional Chinese Medicine, Changzhou City, 213000, Jiangsu Province, China.
Department of Pathology, Changzhou Hospital of Traditional Chinese Medicine, Changzhou City, 213000, Jiangsu Province, China.
出版信息
BMC Med Imaging. 2022 Sep 10;22(1):163. doi: 10.1186/s12880-022-00891-6.
BACKGROUND
This study aims to estimate the amount of axillary lymph node (ALN) involvement in early-stage breast cancer utilizing a field of view (FOV) optimized and constrained undistorted single-shot (FOCUS) diffusion-weighted imaging (DWI) approach, as well as a whole-lesion histogram analysis.
METHODS
This retrospective analysis involved 81 individuals with invasive breast cancer. The patients were divided into three groups: N (negative ALN metastasis), N (low metastatic burden with 1-2 ALNs), and N (heavy metastatic burden with ≥ 3 ALNs) based on their sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). Histogram parameters of apparent diffusion coefficient (ADC) depending basically on FOCUS DWI were performed using 3D-Slicer software for whole lesions. The typical histogram characteristics for N, N, and N were compared to identify the significantly different parameters. To determine the diagnostic efficacy of significantly different factors, the area under their receiver operating characteristic (ROC) curves was examined.
RESULTS
There were significant differences in the energy, maximum, 90 percentile, range, and lesion size among N, N, and N groups (P < 0.05). The energy differed significantly between N and N groups (P < 0.05), and some certain ADC histogram parameters and lesion sizes differed significantly between N and N, or N and N groups. For ROC analysis, the energy yielded the best diagnostic performance in distinguishing N and N groups from N group with an AUC value of0.853. All parameters revealed excellent inter-observer agreement with inter-reader consistencies data ranging from0.919 to 0.982.
CONCLUSION
By employing FOCUS DWI method, the analysis of whole-lesion ADC histogram quantitatively provides a non-invasive way to evaluate the degree of ALN metastatic spread in early-stage breast cancer.
背景
本研究旨在利用视野（FOV）优化和约束无失真单次（FOCUS）弥散加权成像（DWI）方法以及全病变直方图分析，来评估早期乳腺癌腋窝淋巴结（ALN）受累的程度。
方法
本回顾性分析纳入了 81 例浸润性乳腺癌患者。根据前哨淋巴结活检（SLNB）或腋窝淋巴结清扫（ALND）结果，患者被分为 N（阴性 ALN 转移）、N（1-2 个 ALN 低转移负荷）和 N（≥3 个 ALN 高转移负荷）三组。使用 3D-Slicer 软件对全病变进行基于 FOCUS DWI 的表观扩散系数（ADC）直方图参数分析。比较 N、N 和 N 组的典型直方图特征，以确定有显著差异的参数。为了确定有显著差异的因素的诊断效能，评估了其受试者工作特征（ROC）曲线下面积。
结果
N、N 和 N 组之间的能量、最大值、90 百分位数、范围和病变大小存在显著差异（P<0.05）。N 和 N 组之间的能量有显著差异（P<0.05），而某些特定的 ADC 直方图参数和病变大小在 N 和 N 组或 N 和 N 组之间存在显著差异。ROC 分析显示，能量在区分 N 和 N 组与 N 组方面具有最佳的诊断性能，AUC 值为 0.853。所有参数均具有极好的观察者间一致性，观察者间一致性数据范围为 0.919 至 0.982。
结论
采用 FOCUS DWI 方法，对全病变 ADC 直方图进行分析可以定量评估早期乳腺癌 ALN 转移扩散的程度，为一种非侵入性方法。
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