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通过分子类型比较自动乳腺容积扫描与传统超声、乳腺X线摄影及磁共振成像在评估新辅助治疗后残余乳腺癌方面的差异。

Comparison of automated breast volume scanning with conventional ultrasonography, mammography, and MRI to assess residual breast cancer after neoadjuvant therapy by molecular type.

作者信息

Peng Y, Yuan F, Xie F, Yang H, Wang S, Wang C, Yang Y, Du W, Liu M, Wang S

机构信息

Breast Center, Peking University People's Hospital, Beijing, China.

Department of Radiology, Breast Center, Peking University People's Hospital, Beijing, China.

出版信息

Clin Radiol. 2023 May;78(5):e393-e400. doi: 10.1016/j.crad.2022.12.002. Epub 2023 Jan 13.

Abstract

AIM

To compare the accuracy of hand-held ultrasonography (US), mammography (MG), magnetic resonance imaging (MRI), and automated breast volume scanning (ABVS) in defining residual breast cancer tumour size after neoadjuvant therapy (NAT).

MATERIALS AND METHODS

Patients diagnosed breast cancer and who received NAT at the Breast Center, Peking University People's Hospital, were enrolled prospectively. Imaging was performed after the last cycle of NAT. The residual tumour size, intraclass correlation coefficients (ICCs), and receiver operating characteristic (ROC) to predict pathological complete response (pCR) were analysed.

RESULTS

A total of 156 patients with 159 tumours were analysed. ABVS had a moderate correlation with histopathology residual tumour size (ICC = 0.666), and showed high agreement among triple-positive tumours (ICC = 0.797). With 5 mm as the threshold, the coincidence rate reached 64.7% between ABVS and pathological size, which was significantly higher than that between US, MG, MRI, and pathological size (50%, 45.1%, 41.4%; p=0.009, p=0.001, p<0.001, respectively). For ROC analysis, ABVS demonstrated a higher area under the ROC curve, but with no statistical difference, except for MG (0.855, 0.816, 0.819, and 0.788, respectively; p=0.183 for US, p=0.044 for MG, and p=0.397 for MRI, with ABVS as the reference).

CONCLUSIONS

The longest tumour diameter on ABVS had a moderate correlation with pathological residual invasive tumour size. ABVS was shown to have good ability to predict pCR and would appear to be a potential useful tool for the assessment after NAT for breast cancer.

摘要

目的

比较手持超声检查(US)、乳腺钼靶摄影(MG)、磁共振成像(MRI)和自动乳腺容积扫描(ABVS)在新辅助治疗(NAT)后确定残余乳腺癌肿瘤大小方面的准确性。

材料与方法

前瞻性纳入北京大学人民医院乳腺中心诊断为乳腺癌并接受NAT的患者。在NAT的最后一个周期后进行成像检查。分析残余肿瘤大小、组内相关系数(ICC)以及预测病理完全缓解(pCR)的受试者操作特征(ROC)曲线。

结果

共分析了156例患者的159个肿瘤。ABVS与组织病理学残余肿瘤大小具有中等相关性(ICC = 0.666),在三阳性肿瘤中显示出高度一致性(ICC = 0.797)。以5 mm为阈值,ABVS与病理大小之间的符合率达到64.7%,显著高于US、MG、MRI与病理大小之间的符合率(分别为50%、45.1%、41.4%;p = 0.009、p = 0.001、p < 0.001)。对于ROC分析,ABVS显示出较高的ROC曲线下面积,但除MG外无统计学差异(分别为0.855、0.816、0.819和0.788;以ABVS为参照,US的p = 0.183,MG的p = 0.044,MRI的p = 0.397)。

结论

ABVS上最长肿瘤直径与病理残余浸润性肿瘤大小具有中等相关性。ABVS显示出良好的预测pCR的能力,似乎是乳腺癌NAT后评估的一种潜在有用工具。

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