Abstract：
OBJECTIVE: To assess T1 mapping performance in distinguishing between benign and malignant breast lesions and to explore its correlation with histopathologic features in breast cancer.
METHODS: This study prospectively enrolled 103 participants with a total of 108 lesions, including 25 benign and 83 malignant lesions. T1 mapping, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) were performed. Two radiologists independently outlined the ROIs and analyzed T1 and apparent diffusion coefficient (ADC) values for each lesion, assessing interobserver reliability with the intraclass correlation coefficient (ICC). T1 and ADC values were compared between benign and malignant lesions, across different histopathological characteristics (histological grades, estrogen, progesterone and HER2 receptors expression, Ki67, N status). Receiver operating characteristic (ROC) analysis and Pearson correlation coefficient (ρ) were performed.
RESULTS: T1 values showed statistically significant differences between benign and malignant groups (P < 0.001), with higher values in the malignant (1817.08 ms ± 126.64) compared to the benign group (1429.31 ms ± 167.66). In addition, T1 values significantly increased in the ER (-) group (P = 0.001). No significant differences were found in T1 values among HER2, Ki67, N status, and histological grades groups. Furthermore, T1 values exhibited a significant correlation (ρ) with ER (P < 0.01) and PR (P = 0.03). The AUC for T1 value in distinguishing benign from malignant lesions was 0.69 (95 % CI: 0.55 - 0.82, P = 0.005), and for evaluating ER status, it was 0.75 (95 % CI: 0.62 - 0.87, P = 0.002).
CONCLUSIONS: T1 mapping holds the potential as an imaging biomarker to assist in the discrimination of benign and malignant breast lesions and assessing the ER expression status in breast cancer.
METHODS: This study prospectively enrolled 103 participants with a total of 108 lesions, including 25 benign and 83 malignant lesions. T1 mapping, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) were performed. Two radiologists independently outlined the ROIs and analyzed T1 and apparent diffusion coefficient (ADC) values for each lesion, assessing interobserver reliability with the intraclass correlation coefficient (ICC). T1 and ADC values were compared between benign and malignant lesions, across different histopathological characteristics (histological grades, estrogen, progesterone and HER2 receptors expression, Ki67, N status). Receiver operating characteristic (ROC) analysis and Pearson correlation coefficient (ρ) were performed.
RESULTS: T1 values showed statistically significant differences between benign and malignant groups (P < 0.001), with higher values in the malignant (1817.08 ms ± 126.64) compared to the benign group (1429.31 ms ± 167.66). In addition, T1 values significantly increased in the ER (-) group (P = 0.001). No significant differences were found in T1 values among HER2, Ki67, N status, and histological grades groups. Furthermore, T1 values exhibited a significant correlation (ρ) with ER (P < 0.01) and PR (P = 0.03). The AUC for T1 value in distinguishing benign from malignant lesions was 0.69 (95 % CI: 0.55 - 0.82, P = 0.005), and for evaluating ER status, it was 0.75 (95 % CI: 0.62 - 0.87, P = 0.002).
CONCLUSIONS: T1 mapping holds the potential as an imaging biomarker to assist in the discrimination of benign and malignant breast lesions and assessing the ER expression status in breast cancer.
摘要：
目的：评估T1作图在鉴别乳腺良恶性病变中的表现，并探讨其与乳腺癌组织病理学特征的相关性。
方法：本研究前瞻性招募了103名参与者，共108个病灶，其中良性病变25例,恶性病变83例。T1映射,弥散加权成像(DWI),并进行动态对比增强（DCE）。两名放射科医生独立概述了ROI，并分析了每个病变的T1和表观扩散系数（ADC）值。使用组内相关系数(ICC)评估观察者间的可靠性。比较良恶性病变的T1和ADC值，不同的组织病理学特征(组织学等级，雌激素,孕激素和HER2受体表达，Ki67，N状态）。进行接收器工作特性（ROC）分析和皮尔逊相关系数（ρ）。
结果：T1值显示良性和恶性组之间的统计学差异（P<0.001），与良性组（1429.31ms±167.66）相比，恶性组（1817.08ms±126.64）的值更高。此外,ER(-)组T1值显著增加(P=0.001)。T1值在HER2、Ki67、N状态、和组织学分级组。此外，T1值与ER(P<0.01)和PR(P=0.03)呈显著相关。T1值在鉴别良恶性病变中的AUC为0.69(95%CI:0.55-0.82,P=0.005),为了评估ER状态，它是0.75（95%CI：0.62-0.87，P=0.002）。
结论：T1作图具有作为成像生物标志物的潜力，有助于区分良性和恶性乳腺病变并评估乳腺癌中的ER表达状态。
方法：本研究前瞻性招募了103名参与者，共108个病灶，其中良性病变25例,恶性病变83例。T1映射,弥散加权成像(DWI),并进行动态对比增强（DCE）。两名放射科医生独立概述了ROI，并分析了每个病变的T1和表观扩散系数（ADC）值。使用组内相关系数(ICC)评估观察者间的可靠性。比较良恶性病变的T1和ADC值，不同的组织病理学特征(组织学等级，雌激素,孕激素和HER2受体表达，Ki67，N状态）。进行接收器工作特性（ROC）分析和皮尔逊相关系数（ρ）。
结果：T1值显示良性和恶性组之间的统计学差异（P<0.001），与良性组（1429.31ms±167.66）相比，恶性组（1817.08ms±126.64）的值更高。此外,ER(-)组T1值显著增加(P=0.001)。T1值在HER2、Ki67、N状态、和组织学分级组。此外，T1值与ER(P<0.01)和PR(P=0.03)呈显著相关。T1值在鉴别良恶性病变中的AUC为0.69(95%CI:0.55-0.82,P=0.005),为了评估ER状态，它是0.75（95%CI：0.62-0.87，P=0.002）。
结论：T1作图具有作为成像生物标志物的潜力，有助于区分良性和恶性乳腺病变并评估乳腺癌中的ER表达状态。
