Han Yi-Min, Ou Dan, Chai Wei-Min, Yang Wen-Lei, Liu Ying-Long, Xiao Ji-Feng, Zhang Wei, Qi Wei-Xiang, Chen Jia-Yi
Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Department of Radiology, RuiJin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Heliyon. 2024 Apr 18;10(9):e29350. doi: 10.1016/j.heliyon.2024.e29350. eCollection 2024 May 15.
This study aimed to explore the spatial distribution of brain metastases (BMs) from breast cancer (BC) and to identify the high-risk sub-structures in BMs that are involved at first diagnosis.
Magnetic resonance imaging (MRI) scans were retrospectively reviewed at our centre. The brain was divided into eight regions according to its anatomy and function, and the volume of each region was calculated. The identification and volume calculation of metastatic brain lesions were accomplished using an automatically segmented 3D BUC-Net model. The observed and expected rates of BMs were compared using 2-tailed proportional hypothesis testing.
A total of 250 patients with BC who presented with 1694 BMs were retrospectively identified. The overall observed incidences of the substructures were as follows: cerebellum, 42.1 %; frontal lobe, 20.1 %; occipital lobe, 9.7 %; temporal lobe, 8.0 %; parietal lobe, 13.1 %; thalamus, 4.7 %; brainstem, 0.9 %; and hippocampus, 1.3 %. Compared with the expected rate based on the volume of different brain regions, the cerebellum, occipital lobe, and thalamus were identified as higher risk regions for BMs ( value ≤ 5.6*10). Sub-group analysis according to the type of BC indicated that patients with triple-negative BC had a high risk of involvement of the hippocampus and brainstem.
Among patients with BC, the cerebellum, occipital lobe and thalamus were identified as higher-risk regions than expected for BMs. The brainstem and hippocampus were high-risk areas of the BMs in triple negative breast cancer. However, further validation of this conclusion requires a larger sample size.
本研究旨在探讨乳腺癌脑转移瘤（BMs）的空间分布，并确定初诊时受累的BMs高危亚结构。
对本中心的磁共振成像（MRI）扫描进行回顾性分析。根据大脑的解剖结构和功能将其分为八个区域，并计算每个区域的体积。使用自动分割的3D BUC-Net模型完成脑转移瘤的识别和体积计算。采用双尾比例假设检验比较BMs的观察率和预期率。
共回顾性纳入250例患有1694个BMs的乳腺癌患者。各亚结构的总体观察发病率如下：小脑，42.1%；额叶，20.1%；枕叶，9.7%；颞叶，8.0%；顶叶，13.1%；丘脑，4.7%；脑干，0.9%；海马体，1.3%。与基于不同脑区体积的预期率相比，小脑、枕叶和丘脑被确定为BMs的高危区域（ 值≤5.6*10）。根据乳腺癌类型进行的亚组分析表明，三阴性乳腺癌患者海马体和脑干受累风险较高。
在乳腺癌患者中，小脑、枕叶和丘脑被确定为BMs比预期更高风险的区域。脑干和海马体是三阴性乳腺癌BMs的高危区域。然而，这一结论需要更大样本量的进一步验证。
