在临床早期乳腺癌患者中，利用体素内不相干运动扩散加权成像和动态对比增强磁共振成像预测前哨淋巴结转移负荷

Predicting sentinel lymph node metastatic burden with intravoxel incoherent motion diffusion-weighted imaging and dynamic contrast-enhanced magnetic resonance imaging in clinical early-stage breast cancer patients.

作者信息

Jin Mingli, Xiao Fang, Zhao Qi, Jiang Ying, Pan Zhihua, Duan Zhicai, Jiang Juxi, Zhang Miaoqi, Shu Jian

机构信息

Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646099, PR China; Department of Radiology, The Second Affiliated Hospital of Chengdu Medical College, Nuclear Industry 416 Hospital, Chengdu, Sichuan 610051, PR China.

Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui 230036, PR China.

出版信息

Magn Reson Imaging. 2025 Sep;121:110397. doi: 10.1016/j.mri.2025.110397. Epub 2025 Apr 26.

DOI:10.1016/j.mri.2025.110397

PMID:40294765

Abstract

PURPOSE

The goal of this study was to investigate the value of IVIM-MRI and DCE-MRI in predicting SLN metastatic burden in clinical practice for early-stage breast cancer patients.

METHODS

The clinicopathologic and MRI data from 132 early-stage breast cancer patients were retrospectively reviewed and analyzed using logistic regression to identify risk factors for a high SLN metastatic burden. The diagnostic performance of those factors was then assessed via receiver operating characteristic (ROC) curve analysis.

RESULTS

Lymphovascular invasion (OR, 0.220; 95 % CI, 0.076-0.642; p = 0.006), K (OR, 0.971; 95 % CI, 0.944-0.998; p = 0.034) and D (OR, 1.010; 95 % CI, 1.003-1.017; p = 0.004) were independently associated with high metastatic burden. The area under the curve (AUC) for combined MRI & pathologic features (0.893; 95 % CI, 0.830-0.956; p < 0.001) and combined MRI (0.870; 95 % CI, 0.802-0.937; p < 0.001) was significantly higher than for each single MRI parameter alone (p = 0.002, 0.004), while the difference in AUCs between the combined MRI & pathologic features and combined MRI was not significant ((p = 0.154).

CONCLUSION

IVIM-MRI and DCE-MRI can be used to predict SLN metastatic burden in early-stage breast cancer patients in clinical practice.

摘要

目的

本研究的目的是探讨体素内不相干运动磁共振成像（IVIM-MRI）和动态对比增强磁共振成像（DCE-MRI）在临床实践中预测早期乳腺癌患者前哨淋巴结转移负荷的价值。

方法

回顾性分析132例早期乳腺癌患者的临床病理和MRI数据，采用逻辑回归分析确定前哨淋巴结转移负荷高的危险因素。然后通过受试者工作特征（ROC）曲线分析评估这些因素的诊断性能。

结果

淋巴管浸润（OR，0.220；95%CI，0.076-0.642；p = 0.006）、K值（OR，0.971；95%CI，0.944-0.998；p = 0.034）和D值（OR，1.010；95%CI，1.003-1.017；p = 0.004）与高转移负荷独立相关。MRI与病理特征联合（曲线下面积[AUC]为0.893；95%CI，0.830-0.956；p < 0.001）和MRI联合（AUC为0.870；95%CI，0.802-0.937；p < 0.001）的AUC显著高于各单一MRI参数（p = 0.002，0.004），而MRI与病理特征联合和MRI联合之间的AUC差异不显著（p = 0.154）。