Lina Zhang, Ning Ning, Hongbing Liang, Siqi Zhao, Xue Gao, Ailian Liu, Qingwei Song, Xiaoyi Duan, Jie Yang, Lizhi Xie
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Three b values were used for DWI to derive the S index; ADC-diff values were obtained using b = 0 and 1000 s/mm<sup>2</sup>. The different interquartile ranges of percentile S-index and ADC-diff values after treatment were calculated and compared. The assessment was performed at baseline and after two and four NAC cycles. A total of 59 patients were evaluated. There are some correlations of interquartile ranges of S-index parameters and ADC-diff values with histopathological prognostic factors (such as estrogen receptor and human epidermal growth factor receptor 2 expression, all p < 0.05), but no significant differences were found in some other interquartile ranges of S-index parameters or ADC-diff values between progesterone receptor positive and negative or for Ki-67 tumors (all P > 0.05). No differences were found in the dynamic contrast-enhanced MRI characteristics between the two groups. HER-2 expression and kurtosis of the S-index distribution were screened out as independent risk factors for predicting MHR group (p < 0.05, area under the curve (AUC) = 0.811) before NAC. After early NAC (two cycles), only the 10th percentile S index was statistically significant between the two groups (p < 0.05, AUC = 0.714). No significant differences were found in ADC-diff value at any time point of NAC between the two groups (P > 0.1). 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引用次数: 0
摘要
早期肿瘤反应预测有助于避免不必要的化疗疗程,从而避免过度治疗。确定多个表观弥散系数指数(S指数、ADC-diff)是否能有效预测乳腺癌(BC)新辅助化疗(NAC)的早期病理反应非常重要。研究对象包括接受 T1WI、弥散加权成像(DWI)和使用 3 T 系统的动态对比增强磁共振成像的 II 期和 III 期乳腺癌患者。他们被分为两组:主要组织学反应者(MHRs,Miller-Payne G4/5)和非主要组织学反应者(nMHRs,Miller-Payne G1-3)。DWI 使用三个 b 值得出 S 指数;ADC-差异值使用 b = 0 和 1000 s/mm2 得出。计算并比较治疗后百分位数 S 指数和 ADC-diff 值的不同四分位间范围。评估在基线以及两个和四个 NAC 周期后进行。共对 59 名患者进行了评估。S-index 参数和 ADC-diff 值的四分位数间范围与组织病理学预后因素(如雌激素受体和人类表皮生长因子受体 2 的表达,均为 p 0.05)存在一定的相关性。两组患者的动态对比增强 MRI 特征无差异。HER-2表达和S指数分布的峰度被筛选出作为预测MHR组的独立风险因素(P 0.1)。这些研究结果表明,S-指数值可作为BC对NAC病理反应的早期预测指标;ADC-diff作为NAC影像生物标志物的价值需要通过正在进行的多中心前瞻性试验进一步证实。
The contrast-free diffusion MRI multiple index for the early prediction of pathological response to neoadjuvant chemotherapy in breast cancer.
Early tumor response prediction can help avoid overtreatment with unnecessary chemotherapy sessions. It is important to determine whether multiple apparent diffusion coefficient indices (S index, ADC-diff) are effective in the early prediction of pathological response to neoadjuvant chemotherapy (NAC) in breast cancer (BC). Patients with stage II and III BCs who underwent T1WI, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced MRI using a 3 T system were included. They were divided into two groups: major histological responders (MHRs, Miller-Payne G4/5) and nonmajor histological responders (nMHRs, Miller-Payne G1-3). Three b values were used for DWI to derive the S index; ADC-diff values were obtained using b = 0 and 1000 s/mm2. The different interquartile ranges of percentile S-index and ADC-diff values after treatment were calculated and compared. The assessment was performed at baseline and after two and four NAC cycles. A total of 59 patients were evaluated. There are some correlations of interquartile ranges of S-index parameters and ADC-diff values with histopathological prognostic factors (such as estrogen receptor and human epidermal growth factor receptor 2 expression, all p < 0.05), but no significant differences were found in some other interquartile ranges of S-index parameters or ADC-diff values between progesterone receptor positive and negative or for Ki-67 tumors (all P > 0.05). No differences were found in the dynamic contrast-enhanced MRI characteristics between the two groups. HER-2 expression and kurtosis of the S-index distribution were screened out as independent risk factors for predicting MHR group (p < 0.05, area under the curve (AUC) = 0.811) before NAC. After early NAC (two cycles), only the 10th percentile S index was statistically significant between the two groups (p < 0.05, AUC = 0.714). No significant differences were found in ADC-diff value at any time point of NAC between the two groups (P > 0.1). These findings demonstrate that the S-index value may be used as an early predictor of pathological response to NAC in BC; the value of ADC-diff as an imaging biomarker of NAC needs to be further confirmed by ongoing multicenter prospective trials.
期刊介绍:
NMR in Biomedicine is a journal devoted to the publication of original full-length papers, rapid communications and review articles describing the development of magnetic resonance spectroscopy or imaging methods or their use to investigate physiological, biochemical, biophysical or medical problems. Topics for submitted papers should be in one of the following general categories: (a) development of methods and instrumentation for MR of biological systems; (b) studies of normal or diseased organs, tissues or cells; (c) diagnosis or treatment of disease. Reports may cover work on patients or healthy human subjects, in vivo animal experiments, studies of isolated organs or cultured cells, analysis of tissue extracts, NMR theory, experimental techniques, or instrumentation.