目的:三维对比增强磁共振成像(3D-Ce-MRI)是评估新辅助化疗(NAC)的最有力工具。然而,造影剂的使用是侵入性的,贵,耗时,因此,无造影剂成像是优选的。我们旨在使用最大强度投影扩散加权图像(MIP-DWI)和3D-Ce-MRI研究NAC后肿瘤体积的变化。
方法:我们最终纳入了2018年接受NAC的55例乳腺癌患者。所有MRI分析均使用SYNAPSEVINCENT®医学成像系统(FujifilmMedical,东京,日本)。我们之前评估了肿瘤体积,during,在NAC之后。在3D-Ce-MRI上NAC之前的肿瘤体积被称为Pre-CE,并且在NAC期间和之后的那些被称为Post-CE。观察者升高窗口宽度的下端直到肿瘤清晰可见,然后手动删除非肿瘤组织。一个月后,同一位不知道3D-Ce-MRI结果的观察者使用MIP-DWI以相同的方法随机评估肿瘤体积(DWI前和DWI后).比较了ΔCE(Pre-CE-Post-CE/Pre-CE)和ΔDWI(Pre-DWI-Post-DWI/Pre-DWI)之间的肿瘤体积变化以及两种方法(Time-DWI和Time-CE)的处理时间。
结果:我们招募了55名患者。对于纯肿块性病变,ΔDWI和ΔCE之间的Spearmanρ,非质量增强(NME)为0.89(p<0.01),0.63(p<0.01)。Time-DWI明显短于Time-CE(分别为41.3±21.2和199.5±98.3,p<0.01)。
结论:与3D-Ce-MRI相比,非对比增强乳腺MRI能够对NAC后的肿瘤体积变化进行适当且更快的评估,尤其是对于肿块。
OBJECTIVE: Three-dimensional contrast-enhanced magnetic resonance imaging (3D-Ce-MRI) is a most powerful tool for evaluation of neoadjuvant chemotherapy (NAC). However, the use of contrast agent is invasive, expensive, and time consuming, Thus, contrast agent-free imaging is preferable. We aimed to investigate the tumor volume change after NAC using maximum intensity projection diffusion-weighted image (MIP-DWI) and 3D-Ce-MRI.
METHODS: We finally enrolled 55 breast cancer patients who underwent NAC in 2018. All MRI analyses were performed using SYNAPSE VINCENT® medical imaging system (Fujifilm Medical, Tokyo, Japan). We evaluated the tumor volumes before, during, and after NAC. Tumor volume before NAC on 3D-Ce-MRI was termed Pre-CE and those during and after NAC were termed Post-CE. The observer raised the lower end of the window width until the tumor was clearly visible and then manually deleted the non-tumor tissues. A month thereafter, the same observer who was blinded to the 3D-Ce-MRI results randomly evaluated the tumor volumes (Pre-DWI and Post-DWI) using MIP-DWI with the same method. Tumor volume change between ΔCE (Pre-CE - Post-CE/Pre-CE) and ΔDWI (Pre-DWI - Post-DWI/Pre-DWI) and the processing time for both methods (Time-DWI and Time-CE) were compared.
RESULTS: We enrolled 55 patients. Spearman\'s rho between ΔDWI and ΔCE for pure mass lesions, and non-mass enhancement (NME) was 0.89 (p < 0.01), 0.63(p < 0.01) respectively. Time-DWI was significantly shorter than Time-CE (41.3 ± 21.2 and 199.5 ± 98.3 respectively, p < 0.01).
CONCLUSIONS: Non-contrast-enhanced Breast MRI enables appropriate and faster evaluation of tumor volume change after NAC than 3D-Ce-MRI especially for mass lesions.