Liu Fan, Wu Lei, Luo Xinyi, Li Sisi, Wang Yishi, Zhong Wen, Feiweier Thorsten, Xu Junzhong, Shi Diwei, Bao Haihua, Guo Hua
Center for Biomedical Imaging Research, School of Biomedical Engineering, Tsinghua University, Beijing, China.
Qinghai University Affiliated Hospital, Xining, China.
J Magn Reson Imaging. 2025 Mar 11. doi: 10.1002/jmri.29757.
MR cytometry is a class of diffusion-MRI-based methods that characterize tumor microstructures at the cellular level. It involves multicompartmental biophysical modeling of multi-b and multiple diffusion time data to generate microstructural parameters, which may improve differentiation of benign and malignant breast tumors.
To implement MR cytometry imaging with transcytolemmal water exchange (JOINT and EXCHANGE) to differentiate benign and malignant breast tumors, and to compare the classification efficacy of IMPULSED, JOINT, and EXCHANGE.
Prospective.
115 patients with pathologically confirmed breast tumors (25 benign and 90 malignant).
FIELD STRENGTH/SEQUENCE: 3T; pulsed gradient spin-echo (PGSE) diffusion-weighted imaging (DWI) and oscillating gradient spin-echo (OGSE) DWI at 25 and 50 Hz.
Tumor regions were delineated by two radiologists on DWI. Time-dependent ADC and microstructural parameters (cell diameter , intracellular volume fraction , water exchange rate constant , extracellular diffusivity and intracellular intrinsic diffusivity ) were calculated. Classification performance was assessed in the original cohort and in an age-adjusted cohort (excluding older malignant patients to eliminate significant age differences).
Mann-Whitney U-tests compared benign and malignant tumor values. Multivariable logistic regression used a stepwise approach based on the likelihood ratio test. The area under the receiver operating characteristic (AUC) was computed and compared by using the DeLong test.
In the full analysis (25 benign, 90 malignant), microstructural parameters from methods incorporating transcytolemmal water exchange (JOINT and EXCHANGE) demonstrated superior performance (AUC: ADC, 0.822; IMPULSED, 0.840; JOINT, 0.902; EXCHANGE, 0.905). Combining different metrics further improved classification (AUC: IMPULSED [ , ], 0.942; JOINT [ , ], 0.956; EXCHANGE [ , ], 0.954; [ ], 0.927). These improvements were also observed in the age-adjusted analysis (25 benign, 42 malignant).
MR cytometry outperformed ADC in distinguishing benign and malignant breast tumors. Incorporating transcytolemmal water exchange into biophysical modeling further improved its diagnostic performance.
1 Technical Efficacy: Stage 2.
磁共振细胞术是一类基于扩散磁共振成像的方法，可在细胞水平表征肿瘤微结构。它涉及对多b值和多个扩散时间数据进行多房室生物物理建模以生成微结构参数，这可能有助于提高乳腺良恶性肿瘤的鉴别能力。
采用跨细胞膜水交换（JOINT和EXCHANGE）实现磁共振细胞术成像，以鉴别乳腺良恶性肿瘤，并比较IMPULSED、JOINT和EXCHANGE的分类效能。
前瞻性研究。
115例经病理证实的乳腺肿瘤患者（25例良性，90例恶性）。
场强/序列：3T；25Hz和50Hz的脉冲梯度自旋回波（PGSE）扩散加权成像（DWI）以及振荡梯度自旋回波（OGSE）DWI。
两名放射科医生在DWI上勾勒出肿瘤区域。计算时间依赖性表观扩散系数（ADC）和微结构参数（细胞直径、细胞内体积分数、水交换速率常数、细胞外扩散率和细胞内固有扩散率）。在原始队列和年龄调整队列（排除年龄较大的恶性患者以消除显著的年龄差异）中评估分类性能。
采用曼-惠特尼U检验比较良性和恶性肿瘤值。多变量逻辑回归采用基于似然比检验的逐步方法。通过使用德龙检验计算并比较受试者操作特征曲线（AUC）下的面积。
在全面分析中（25例良性，90例恶性），纳入跨细胞膜水交换的方法（JOINT和EXCHANGE）得到的微结构参数表现更优（AUC：ADC为0.822；IMPULSED为0.840；JOINT为0.902；EXCHANGE为0.905）。结合不同指标可进一步提高分类效能（AUC：IMPULSED[ ， ]为0.942；JOINT[ ， ]为0.956；EXCHANGE[ ， ]为0.954；[ ]为0.927）。在年龄调整分析（25例良性，42例恶性）中也观察到了这些改善。
在鉴别乳腺良恶性肿瘤方面，磁共振细胞术优于ADC。将跨细胞膜水交换纳入生物物理建模可进一步提高其诊断性能。
1 技术效能：2级。
