乳腺病变中基于T1映射得出的参数：诊断准确性及其与病理特征的相关性

T1 Mapping-Derived Parameters in Breast Lesions: Diagnostic Accuracy and Correlation with Pathologic Features.

作者信息

Sun Shanshan, Wang Shouju, Tang Yuxia, Liu Kaiwen, Lin Zengping, Song Yutong, Wu Feiyun, Jin Yingying

机构信息

Department of Radiology, The First Affiliated Hospital with Nanjing Medical University, NO. 300, Guangzhou Road, Nanjing, Jiangsu 210029, China (S.S., S.W., Y.T., K.L., Y.S., F.W., Y.J.).

Department of Radiology, The First Affiliated Hospital with Nanjing Medical University, NO. 300, Guangzhou Road, Nanjing, Jiangsu 210029, China (S.S., S.W., Y.T., K.L., Y.S., F.W., Y.J.); Laboratory of Molecular Imaging, Department of Radiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China (S.W., Y.T., K.L., Y.J.).

出版信息

Acad Radiol. 2025 Jul;32(7):3870-3882. doi: 10.1016/j.acra.2025.03.029. Epub 2025 Apr 9.

DOI:10.1016/j.acra.2025.03.029

PMID:40204585

Abstract

RATIONALE AND OBJECTIVES

To evaluate the diagnostic potential of T1 mapping-derived parameters for distinguishing between benign and malignant breast tumors and their associations with pathologic prognostic indicators in invasive breast cancer.

MATERIALS AND METHODS

Patients who underwent breast surgery and quantitative magnetic resonance imaging (MRI), including apparent diffusion coefficient (ADC) and T1 mapping, between August 2023 and March 2024 were prospectively included. T1 parameters, including lesion T1 values before and after contrast agent injection (T10, T1c), reduction in T1 value (ΔT1), ratio of reduction (ΔT1%), extracellular volume fractions (ECVs), and ADC values were compared between benign and malignant breast lesions. The classification effect was evaluated via receiver operating characteristic (ROC) curves, and the correlation between MRI parameters and each prognostic indicator in invasive ductal carcinoma (IDC) was analyzed via Spearman correlation.

RESULTS

The ROC curves revealed that the area under the curve (AUC) of the ECV was slightly larger than that of the ADC (0.90 [95% CI: 0.84-0.95] vs 0.89 [95% CI: 0.83-0.94]). The combined diagnostic model of all parameters had the highest AUC (0.95 [95% CI: 0.90-0.98]). In IDC, ECV was positively correlated with the expression of estrogen receptor (r = 0.449, P < .001) and progesterone receptor (r = 0.433, P < .001) and negatively correlated with Ki-67 protein expression (r = -0.407, P < .001). No correlation was found between the ADC values and prognostic indicators.

CONCLUSION

T1 parameters can effectively differentiate benign and malignant breast lesions and have potential utility in predicting tumor invasiveness.

摘要

原理与目的

评估T1映射衍生参数在鉴别乳腺良恶性肿瘤中的诊断潜力及其与浸润性乳腺癌病理预后指标的相关性。

材料与方法

前瞻性纳入2023年8月至2024年3月期间接受乳腺手术及定量磁共振成像（MRI）检查的患者，检查包括表观扩散系数（ADC）和T1映射。比较乳腺良恶性病变之间的T1参数，包括注射造影剂前后的病变T1值（T10、T1c）、T1值降低量（ΔT1）、降低率（ΔT1%）、细胞外容积分数（ECV）以及ADC值。通过受试者操作特征（ROC）曲线评估分类效果，并通过Spearman相关性分析MRI参数与浸润性导管癌（IDC）各预后指标之间的相关性。

结果

ROC曲线显示，ECV的曲线下面积（AUC）略大于ADC（0.90 [95%CI：0.84 - 0.95] 对比0.89 [95%CI：0.83 - 0.94]）。所有参数的联合诊断模型具有最高的AUC（0.95 [95%CI：0.90 - 0.98]）。在IDC中，ECV与雌激素受体表达呈正相关（r = 0.449，P <.001）和孕激素受体表达呈正相关（r = 0.433，P <.001），与Ki-67蛋白表达呈负相关（r = -0.407，P <.001）。未发现ADC值与预后指标之间存在相关性。