三维酰胺质子转移加权成像可用于诊断早期乳腺癌：一项前瞻性单中心研究

IF 3.7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING European Radiology Experimental Pub Date : 2024-04-08 DOI:10.1186/s41747-024-00439-z

Yeqin Li, Yan Zhang, Liwen Tian, Ju Li, Huihua Li, Ximing Wang, Cuiyan Wang

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引用次数: 0

摘要

背景我们研究了三维酰胺质子转移加权成像（3D-APTWI）在早期乳腺癌（BC）诊断中的价值及其与恶性病变免疫组化特征的相关性。病理结果分为良性病变（43 例）和恶性病变（37 例）。良性组和恶性组的 APTWI 和 DCE-MRI 参数进行了比较。使用接收者操作特征曲线下面积（ROC-AUC）评估 3D-APTWI 的诊断价值，以确定诊断阈值。结果恶性肿瘤的磁化转移不对称性（MTRasym）和峰值时间显著低于良性病变（均为 p <0.010）。恶性肿瘤的体积转移常数、速率常数、洗入率和洗出率均明显高于良性病变（均 p < 0.010）。3D-APTWI、DCE-MRI 和 3D-APTWI+DCE 鉴别诊断早期 BC 和良性病变的 ROC-AUC 分别为 0.816、0.745 和 0.858。只有 AUCAPT+DCE 和 AUCDCE 之间的差异具有显著性（p < 0.010）。当 MTRasym 的恶性阈值为 2.42% 时，3D-APTWI 对 BC 诊断的敏感性和特异性分别为 86.5% 和 67.6%；MTRasym 与病理分级（r = 0.476，p = 0.003）和 Ki-67 （r = 0.419，p = 0.020）呈轻度正相关。相关性声明3D-APTWI可作为不适合注射造影剂的早期乳腺癌患者的替代诊断方法。关键点-3D-APTWI反映了早期乳腺癌微环境的变化。

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3D amide proton transfer-weighted imaging may be useful for diagnosing early-stage breast cancer: a prospective monocentric study

Background

We investigated the value of three-dimensional amide proton transfer-weighted imaging (3D-APTWI) in the diagnosis of early-stage breast cancer (BC) and its correlation with the immunohistochemical characteristics of malignant lesions.

Methods

Seventy-eight women underwent APTWI and dynamic contrast-enhanced (DCE)-MRI. Pathological results were categorized as either benign (n = 43) or malignant (n = 37) lesions. The parameters of APTWI and DCE-MRI were compared between the benign and malignant groups. The diagnostic value of 3D-APTWI was evaluated using the area under the receiver operating characteristic curve (ROC-AUC) to establish a diagnostic threshold. Pearson’s correlation was used to analyze the correlation between the magnetization transfer asymmetry (MTR_asym) and immunohistochemical characteristics.

Results

The MTR_asym and time-to-peak of malignancies were significantly lower than those of benign lesions (all p < 0.010). The volume transfer constant, rate constant, and wash-in and wash-out rates of malignancies were all significantly greater than those of benign lesions (all p < 0.010). ROC-AUCs of 3D-APTWI, DCE-MRI, and 3D-APTWI+DCE to differential diagnosis between early-stage BC and benign lesions were 0.816, 0.745, and 0.858, respectively. Only the difference between AUC_APT+DCE and AUC_DCE was significant (p < 0.010). When a threshold of MTR_asym for malignancy for 2.42%, the sensitivity and specificity of 3D-APTWI for BC diagnosis were 86.5% and 67.6%, respectively; MTR_asym was modestly positively correlated with pathological grade (r = 0.476, p = 0.003) and Ki-67 (r = 0.419, p = 0.020).

Conclusions

3D-APTWI may be used as a supplementary method for patients with contraindications of DCE-MRI. MTR_asym can imply the proliferation activities of early-stage BC.