Department of Radiology, Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX 75390, USA.
Department of Radiology, Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX 75390, USA.
Magn Reson Imaging Clin N Am. 2024 Feb;32(1):135-150. doi: 10.1016/j.mric.2023.09.012. Epub 2023 Oct 19.
Breast cancer is the most frequently diagnosed cancer among women worldwide, carrying a significant socioeconomic burden. Breast cancer is a heterogeneous disease with 4 major subtypes identified. Each subtype has unique prognostic factors, risks, treatment responses, and survival rates. Advances in targeted therapies have considerably improved the 5-year survival rates for primary breast cancer patients largely due to widespread screening programs that enable early detection and timely treatment. Imaging techniques are indispensable in diagnosing and managing breast cancer. While mammography is the primary screening tool, MRI plays a significant role when mammography results are inconclusive or in patients with dense breast tissue. MRI has become standard in breast cancer imaging, providing detailed anatomic and functional data, including tumor perfusion and cellularity. A key characteristic of breast tumors is angiogenesis, a biological process that promotes tumor development and growth. Increased angiogenesis in tumors generally indicates poor prognosis and increased risk of metastasis. Dynamic contrast-enhanced (DCE) MRI measures tumor perfusion and serves as an in vivo metric for angiogenesis. DCE-MRI has become the cornerstone of breast MRI, boasting a high negative-predictive value of 89% to 99%, although its specificity can vary. This review presents a thorough overview of magnetic resonance (MR) perfusion imaging in breast cancer, focusing on the role of DCE-MRI in clinical applications and exploring emerging MR perfusion imaging techniques.
乳腺癌是全球女性最常见的癌症，给社会经济带来了重大负担。乳腺癌是一种异质性疾病，可分为 4 种主要亚型。每种亚型都有独特的预后因素、风险、治疗反应和生存率。靶向治疗的进步大大提高了原发性乳腺癌患者的 5 年生存率，这主要得益于广泛的筛查计划，使早期发现和及时治疗成为可能。影像学技术在诊断和管理乳腺癌中不可或缺。虽然乳腺 X 线摄影是主要的筛查工具，但在乳腺 X 线摄影结果不确定或乳腺组织致密的患者中，磁共振成像（MRI）发挥着重要作用。MRI 已成为乳腺癌成像的标准，提供详细的解剖和功能数据，包括肿瘤灌注和细胞密度。乳腺癌肿瘤的一个关键特征是血管生成，这是促进肿瘤发展和生长的生物学过程。肿瘤内血管生成增加通常预示着预后不良和转移风险增加。动态对比增强（DCE）MRI 测量肿瘤灌注，是血管生成的体内指标。DCE-MRI 已成为乳腺 MRI 的基石，具有 89%至 99%的高阴性预测值，尽管其特异性可能有所不同。本文全面综述了乳腺癌的磁共振（MR）灌注成像，重点介绍 DCE-MRI 在临床应用中的作用，并探讨了新兴的 MR 灌注成像技术。
