Bounias Dimitrios, Führes Tobit, Brock Luise, Graber Johanna, Kapsner Lorenz A, Liebert Andrzej, Schreiter Hannes, Eberle Jessica, Hadler Dominique, Skwierawska Dominika, Floca Ralf, Neher Peter, Kovacs Balint, Wenkel Evelyn, Ohlmeyer Sabine, Uder Michael, Maier-Hein Klaus, Bickelhaupt Sebastian
German Cancer Research Center (DKFZ) Heidelberg, Division of Medical Image Computing, Im Neuenheimer Feld 280, Heidelberg, Germany.
Medical Faculty Heidelberg, Heidelberg University, Im Neuenheimer Feld 672, Heidelberg, Germany.
Nat Commun. 2025 Jun 12;16(1):5299. doi: 10.1038/s41467-025-59694-2.
Prognosis for thoracic aortic aneurysms is significantly worse for women than men, with a higher mortality rate observed among female patients. The increasing use of magnetic resonance breast imaging (MRI) offers a unique opportunity for simultaneous detection of both breast cancer and thoracic aortic aneurysms. We retrospectively validate a fully-automated artificial neural network (ANN) pipeline on 5057 breast MRI examinations from public (Duke University Hospital/EA1141 trial) and in-house (Erlangen University Hospital) data. The ANN, benchmarked against 3D-ground-truth segmentations, clinical reports, and a multireader panel, demonstrates high technical robustness (dice/clDice 0.88-0.91/0.97-0.99) across different vendors and field strengths. The ANN improves aneurysm detection rates by 3.5-fold compared with routine clinical readings, highlighting its potential to improve early diagnosis and patient outcomes. Notably, a higher odds ratio (OR = 2.29, CI: [0.55,9.61]) for thoracic aortic aneurysms is observed in women with breast cancer or breast cancer history, suggesting potential further benefits from integrated simultaneous assessment for cancer and aortic aneurysms.
胸主动脉瘤女性患者的预后明显比男性差，女性患者的死亡率更高。磁共振乳腺成像（MRI）的使用日益增加，为同时检测乳腺癌和胸主动脉瘤提供了独特的机会。我们对来自公共（杜克大学医院/EA1141试验）和内部（埃尔朗根大学医院）数据的5057例乳腺MRI检查进行回顾性验证，建立了一个全自动人工神经网络（ANN）流程。该ANN以三维地面真值分割、临床报告和多读者小组为基准，在不同供应商和场强下均显示出较高的技术稳健性（骰子系数/clDice为0.88 - 0.91/0.97 - 0.99）。与常规临床读数相比，ANN将动脉瘤检测率提高了3.5倍，突出了其改善早期诊断和患者预后的潜力。值得注意的是，在患有乳腺癌或有乳腺癌病史的女性中，观察到胸主动脉瘤的优势比更高（OR = 2.29，CI：[0.55,9.61]），这表明对癌症和主动脉瘤进行综合同步评估可能会带来更多益处。
