| 张仁知,周纯武,李静,欧阳汉,王少明.表观扩散系数值预测乳腺癌新辅助化疗疗效的前瞻性研究[J].中国医学影像技术,2013,29(5):731~735 |
| 表观扩散系数值预测乳腺癌新辅助化疗疗效的前瞻性研究 |
| Predictive value of ADC for the effect of neoadjuvant chemotheraphy on breast cancer：A prospective exploration |
| 投稿时间：2013-02-04 修订日期：2013-03-10 |
| DOI： |
| 中文关键词: 乳腺肿瘤 新辅助化疗 磁共振成像 表观扩散系数 |
| 英文关键词:Breast neoplasms Neoadjuvant chemotherapy Magnetic resonance imaging Apparent diffusion coefficient |
| 基金项目:"十一五"国家科技支撑计划课题(2007BAI05B05)。 |
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| 中文摘要: |
| 目的 探讨3.0T MRI采用不同b值DWI扫描,不同ADC值测量方法,乳腺癌新辅助化疗(NAC)前、后病灶ADC值对疗效的预测价值。方法 应用3.0T MR对90例经核芯针穿刺病理证实为浸润性乳腺癌,且临床进行NAC的患者在化疗前、后行乳腺扫描,扫描序列包括常规平扫、DWI及VIBRANT动态增强扫描。采用低值法和手绘法分别对不同b值(b=600、1000 s/mm2)时,化疗前、后病灶进行ADC值测量。采用SPSS 17.0进行分析,术后不同MP分级病灶的ADC值的比较采用t检验。以组织学显著反应(MHR)为阳性,绘制ROC曲线,计算NAC后病灶ADC值预测MHR的最佳临界值。结果 b=600 s/mm2和b=1000 s/mm2时,低值法和手绘法测得NAC后MHR组病变ADC值均高于NMHR组(P均<0.05)。当b=600 s/mm2和b=1000 s/mm2时,乳腺癌NAC后,低值法、手绘法所得化疗后病灶ADC值最佳临界预测值分别为1.52×10-3 mm2/s、1.58×10-3 mm2/s和1.17×10-3 mm2/s、1.27×10-3 mm2/s;最佳临界点下,两种b值预测术后MP分级的敏感度均为88.90%,特异度b=600 s/mm2(低值法:75.551%;手绘法75.51%)时略优于b=1000 s/mm2(低值法:65.42%;手缓法:71.24%)。结论 对于乳腺癌NAC后病灶,采用不同b值和不同ADC测量方法,所得病灶ADC值均可较好地预测术后疗效MP分级。 |
| 英文摘要: |
| Objective To investigate the predictive value of ADC for the effect of neoadjuvant chemotherapy (NAC) of breast cancer with different diffusion sensitivity coefficient b and ADC measurement methods using 3.0T MR scanner. Methods Ninety patients with invasive breast cancer confirmed by core needle puncture biopsy underwent breast MR scans before and after NAC. The scan series included routine plain scan, DWI and volume imaging of breast enhancement (VIBRANT). ADC value of the lesions was measured by the lowest ADC value method and the freehand lesion ADC method under different DWI b values (b=600 s/mm2, 1000 s/mm2) and different time points of NAC. Software SPSS 17.0 was used for analysis, and t test was used to compare ADC value of different MP classifications after NAC. ROC was used to find the optimal cutoff ADC value for the prediction of the major histological response (MHR). Results Either b=600 s/mm2 or b=1000 s/mm2, ADC value of the MHR group was higher than that of non-major histological response (NMHR) group (P<0.05) for both methods. The optimal cutoff ADC value measured by the lowest ADC value method and the freehand lesion ADC method was 1.52×10-3 mm2/s and 1.58×10-3 mm2/s, 1.17×10-3 mm2/s and 1.27×10-3 mm2/s, for b=600 s/mm2 and b=1000 s/mm2, respectively. Same sensitivity (88.90%) was observed for different b values under the optimal ADC cutoff, while a higher specificity was found for b=600 s/mm2 (lowest ADC value method: 75.51%; freehand lesion ADC method: 75.51%) than that of b=1000 s/mm2 (lowest ADC value method: 65.42%; freehand lesion ADC method: 71.24%). Conclusion For breast cancer after NAC, ADC value can be used for the prediction of the MP classification after surgical therapy, regardless of different ADC measurement methods and different DWI b values. |
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