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Abstract：
Purpose To determine whether metrics from mean apparent propagator (MAP) MRI perform better than apparent diffusion coefficient (ADC) value in assessing the tumor-stroma ratio (TSR) status in breast carcinoma. Materials and Methods From August 2021 to October 2022, 271 participants were prospectively enrolled (ClinicalTrials.gov identifier: NCT05159323) and underwent breast diffusion spectral imaging and diffusion-weighted imaging. MAP MRI metrics and ADC were derived from the diffusion MRI data. All participants were divided into high-TSR (stromal component < 50%) and low-TSR (stromal component ≥ 50%) groups based on pathologic examination. Clinicopathologic characteristics were collected, and MRI findings were assessed. Logistic regression was used to determine the independent variables for distinguishing TSR status. The area under the receiver operating characteristic curve (AUC) and sensitivity, specificity, and accuracy were compared between the MAP MRI metrics, either alone or combined with clinicopathologic characteristics, and ADC, using the DeLong and McNemar test. Results A total of 181 female participants (mean age, 49 years ± 10 [SD]) were included. All diffusion MRI metrics differed between the high-TSR and low-TSR groups (P < .001 to P = .01). Radial non-Gaussianity from MAP MRI and lymphovascular invasion were significant independent variables for discriminating the two groups, with a higher AUC (0.81 [95% CI: 0.74, 0.87] vs 0.61 [95% CI: 0.53, 0.68], P < .001) and accuracy (138 of 181 [76%] vs 106 of 181 [59%], P < .001) than that of the ADC. Conclusion MAP MRI may serve as a better approach than conventional diffusion-weighted imaging in evaluating the TSR of breast carcinoma. Keywords: MR Diffusion-weighted Imaging, MR Imaging, Breast, Oncology ClinicalTrials.gov Identifier: NCT05159323 Supplemental material is available for this article. © RSNA, 2024.
摘要：
目的确定平均表观传播因子（MAP）MRI的指标在评估乳腺癌的肿瘤基质比（TSR）状态方面是否优于表观扩散系数（ADC）值。材料和方法从2021年8月至2022年10月，271名参与者被前瞻性纳入（ClinicalTrials.gov标识符：NCT05159323），并接受了乳腺扩散光谱成像和扩散加权成像。MAPMRI指标和ADC来自扩散MRI数据。根据病理检查将所有参与者分为高TSR（基质成分<50％）和低TSR（基质成分≥50％）组。收集临床病理特征，和MRI检查结果进行评估。使用Logistic回归来确定用于区分TSR状态的独立变量。接收器工作特性曲线下面积(AUC)和灵敏度,特异性，和准确性在MAPMRI指标之间进行了比较，单独或结合临床病理特征，ADC,使用DeLong和McNemar测试.结果共有181名女性参与者(平均年龄，包括49年±10[SD]）。高TSR和低TSR组之间的所有扩散MRI指标均不同（P<.001至P=.01）。MAPMRI的径向非高斯性和淋巴管浸润是区分两组的重要独立变量，AUC较高（0.81[95%CI：0.74，0.87]vs0.61[95%CI：0.53，0.68]，P<.001）和准确性（181中的138个[76%]与181中的106个[59%]，P<.001)高于ADC。结论MAPMRI可作为评价乳腺癌TSR的较常规扩散加权成像更好的方法。关键词:磁共振扩散加权成像,MR成像,乳房,肿瘤学ClinicalTrials.gov标识符：NCT05159323补充材料可用于本文。©RSNA,2024.
