Department of Radiology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong, China.
Department of Radiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China.
Eur J Radiol. 2023 Sep;166:111003. doi: 10.1016/j.ejrad.2023.111003. Epub 2023 Jul 22.
To assess the continuous-time random-walk (CTRW) model's diagnostic value in breast lesions and to explore the associations between the CTRW parameters and breast cancer pathologic factors.
This retrospective study included 85 patients (70 malignant and 18 benign lesions) who underwent 3.0T MRI examinations. Diffusion-weighted images (DWI) were acquired with 16b-values to fit the CTRW model. Three parameters (D, α, and β) derived from CTRW and apparent diffusion coefficient (ADC) from DWI were compared among the benign/malignant lesions, molecular prognostic factors, and molecular subtypes by Mann-Whitney U test. Spearman correlation was used to evaluate the associations between the parameters and prognostic factors. The diagnostic performance was assessed by the area under the receiver operating characteristic curve (AUC) based on the diffusion parameters.
All parameters, ADC, D, α, and β were significantly lower in the malignant than benign lesions (P < 0.05). The combination of all the CTRW parameters (D, α, and β) provided the highest AUC (0.833) and the best sensitivity (94.3%) in differentiating malignant status. And the positive status of estrogen receptor (ER) and progesterone receptor (PR) showed significantly lower β compared with the negative counterparts (P < 0.05). The high Ki-67 expression produced significantly lower D and ADC values (P < 0.05). Additionally, combining multiple CTRW parameters improved the performance of diagnosing molecular subtypes of breast cancer. Moreover, Spearman correlations analysis showed that β produced significant correlations with ER, PR and Ki-67 expression (P < 0.05).
The CTRW parameters could be used as non-invasive quantitative imaging markers to evaluate breast lesions.
评估连续时间随机游走（CTRW）模型在乳腺病变中的诊断价值，并探讨 CTRW 参数与乳腺癌病理因素之间的关系。
本回顾性研究纳入 85 名患者（70 例恶性病变和 18 例良性病变），均行 3.0T MRI 检查。采用 16 个 b 值采集扩散加权图像（DWI）以拟合 CTRW 模型。通过 Mann-Whitney U 检验比较良性/恶性病变、分子预后因素和分子亚型之间的 CTRW 衍生的三个参数（D、α和β）和 DWI 的表观扩散系数（ADC）。采用 Spearman 相关分析评估参数与预后因素之间的相关性。基于扩散参数的受试者工作特征曲线（AUC）评估诊断性能。
恶性病变的所有参数（ADC、D、α和β）均显著低于良性病变（P<0.05）。所有 CTRW 参数（D、α和β）的组合在区分恶性状态方面具有最高的 AUC（0.833）和最佳的敏感性（94.3%）。与阴性对照相比，雌激素受体（ER）和孕激素受体（PR）阳性状态的β显著较低（P<0.05）。高 Ki-67 表达导致 D 和 ADC 值显著降低（P<0.05）。此外，结合多个 CTRW 参数可提高乳腺癌分子亚型诊断的性能。此外，Spearman 相关分析显示β与 ER、PR 和 Ki-67 表达具有显著相关性（P<0.05）。
CTRW 参数可用作评估乳腺病变的无创定量成像标志物。
