|
Features from computerized Texture analysis of Breast cancers at Pretreatment Mr imaging are associated with response to neoadjuvant chemotherapy 乳腺癌化療前MR成像的計(jì)算機(jī)紋理分析的特征與新輔助化療療效的相關(guān)性
深圳市人民醫(yī)院 2016級(jí)規(guī)培醫(yī)師 楊熹 2017-12-18 
Original ResearchBreast ImagingFeatures from Computerized Texture Analysis of Breast Cancers at Pretreatment MR Imaging Are Associated with Response to Neoadjuvant ChemotherapyAuthor List Foucauld Chamming’s, MD, PhD, Yoshiko Ueno, MD, Romuald Ferré, MD, Ellen Kao, MD, Anne-Sophie Jannot, MD, PhD, Jaron Chong,MD, Atilla Omeroglu, MD, Beno?t Mesurolle, MD, Caroline Reinhold, MD, MSc, Benoit Gallix, MD
Additional Information From the Departments of Radiology (F.C., Y.U., R.F., E.K., J.C., B.M., C.R., B.G.) and Pathology (A.O.), McGill University Health Centre, Montréal, QC, Canada; and Departments of Radiology (F.C.) and Data Processing and Statistics (A.S.J.), Université Paris Descartes Sorbonne Paris Cité, Assistance Publique-H?pitaux de Paris, H?pital Européen Georges Pompidou, 20 rue Leblanc, 75908 Paris, France.
Address correspondence to F.C. (e-mail: foucauld.chammings@aphp.fr). https:///10.1148/radiol.2017170143
Purpose To evaluate whether features from texture analysis of breast cancers were associated with pathologic complete response (pCR) after neoadjuvant chemotherapy and to explore the association between texture features and tumor subtypes at pretreatment magnetic resonance (MR) imaging.
Materials and Methods Institutional review board approval was obtained. This retrospective study included 85 patients with 85 breast cancers who underwent breast MR imaging before neoadjuvant chemotherapy between April 10, 2008, and March 12, 2015. Two-dimensional texture analysis was performed by using software at T2-weighted MR imaging and contrast material–enhanced T1-weighted MR imaging. Quantitative parameters were compared between patients with pCR and those with non-pCR and between patients with triple-negative breast cancer and those with non–triple-negative cancer. Multiple logistic regression analysis was used to determine independent parameters.
Results Eighteen tumors (22%) were triple-negative breast cancers. pCR was achieved in 30 of the 85 tumors (35%). At univariate analysis, mean pixel intensity with spatial scaling factor (SSF) of 2 and 4 on T2-weighted images and kurtosis on contrast-enhanced T1-weighted images showed a significant difference between triple-negative breast cancer and non–triple-negative breast cancer (P = .009, .003, and .001, respectively). Kurtosis (SSF, 2) on T2-weighted images showed a significant difference between pCR and non-pCR (P = .015). At multiple logistic regression, kurtosis on T2-weighted images was independently associated with pCR in non–triple-negative breast cancer (P = .033). A multivariate model incorporating T2-weighted and contrast-enhanced T1-weighted kurtosis showed good performance for the identification of triple-negative breast cancer (area under the receiver operating characteristic curve, 0.834).
Conclusion At pretreatment MR imaging, kurtosis appears to be associated with pCR to neoadjuvant chemotherapy in non–triple-negative breast cancer and may be a promising biomarker for the identification of triple-negative breast cancer. ? RSNA, 2017
Features from Computerized Texture Analysis of Breast Cancers at Pretreatment MR Imaging Are Associated with Response to Neoadjuvant Chemotherapy Foucauld Chamming’s, Yoshiko Ueno, Romuald Ferré, Ellen Kao, Anne-Sophie Jannot, Jaron Chong, Atilla Omeroglu, Beno?t Mesurolle, Caroline Reinhold, and Benoit Gallix Radiology 0 0:0
評(píng)估乳腺癌紋理分析的特征是否與新輔助化療后病理完全緩解（pCR）狀態(tài)相關(guān)。 探討在乳腺癌化療前MR成像上紋理特征與腫瘤亞型之間的關(guān)系。
pCR（pathologic complete response ）定義：乳腺癌原發(fā)灶和腋 窩淋巴結(jié)手術(shù)標(biāo)本病理檢查無浸潤(rùn)性腫瘤細(xì)胞殘留（但可能存在原位 癌）。 
研究人群：2008年4月10日至2015年3月12日85名浸潤(rùn)性乳腺癌患者，平 均年齡為50歲，年齡范圍30-73歲。
基本流程：在接受新輔助化療前行常規(guī)T2WI和T1WI動(dòng)態(tài)增強(qiáng)掃描，使用后 處理軟件對(duì)圖像進(jìn)行二維分析處理。對(duì)pCR患者組和非pCR患者 組以及三陰性乳腺癌患者組和非三陰性患者組進(jìn)行定量參數(shù)比 較。 分析方法：多重邏輯回歸分析 三陰性乳腺癌定義(triple-negative breast cancerTNBC)：是指雌激素受體、孕激素受體與生長(zhǎng)因子受體均為陰性的乳腺癌，它具有強(qiáng)侵襲性、高復(fù)發(fā)率、高轉(zhuǎn)移率及較差預(yù)后率等特點(diǎn)。 
三陰乳腺癌和非三陰性乳腺癌在T2WI圖像上的平均像素強(qiáng)度（SSF為2和4）和在T1WI增強(qiáng)圖像上的峰度有明顯的差異。
pCR組和非pCR組在T2WI圖像上的峰度（SSF=2）有顯著差異。
在非三陰性乳腺癌患者組中，T2WI圖像上的峰度與pCR獨(dú)立相關(guān)。 在T2WI和T1WI增強(qiáng)峰度圖的多變量模型中鑒定三陰性乳腺癌有很大的優(yōu)勢(shì)。 
在乳腺癌治療前MR成像中，峰度似與非三陰性乳腺癌新輔助化療手術(shù)后的pCR狀態(tài)相關(guān)，并可能成為鑒定三陰性乳腺癌極有價(jià)值的標(biāo)志物。
新輔助化療能通過縮小腫瘤的大小，可使更多的病人接受外科手術(shù)，同時(shí)也能達(dá)到與輔助化療相似的治療效果，提高總體生存率。 
pCR與非pCR患者的MR圖像病灶類型、最大腫瘤大小、患者年齡和雌激素受體、孕激素受體和HER2受體沒有顯著的差異。 三陰性乳腺癌患者的病理完全緩解率67%（18例中12例）顯著高于非三陰性乳腺癌患者26.7%（67例中18例）。 化療前三陰性乳腺癌組的腫瘤平均直徑（30mm;范圍21-35mm）明顯比非三陰性乳腺癌組?。?4mm;直徑范圍34-57mm）。 在T2WI序列上的峰度圖像與非三陰性患者的pCR獨(dú)立相關(guān)。
1.峰度與PCR相關(guān)，它有助于鑒別三陰性乳腺癌。
2.此次研究結(jié)果顯示峰度與非三陰性乳腺癌組中的pCR獨(dú)立相關(guān)，但在三陰乳腺癌組或整個(gè)研究群體中不顯示任何顯著相關(guān)性，可能是由于統(tǒng)計(jì)分析缺乏說服力。 3.研究結(jié)果與以前的出版物結(jié)果一致，三陰性乳腺癌在MR形態(tài)和功能成像上可能具有顯著的區(qū)別。更具體地說，MR紋理參數(shù)分析有助于確定三陰性乳腺癌并幫助預(yù)測(cè)生存及預(yù)后，然而，不同腫瘤亞型的紋理參數(shù)的統(tǒng)計(jì)學(xué)差異在近期不太可能具有任何臨床應(yīng)用價(jià)值，活檢將仍然是高精度確定三陰乳腺癌的金標(biāo)準(zhǔn)。
本次研究?jī)?yōu)勢(shì)
1、此次實(shí)驗(yàn)不僅研究T1WI成像，而且還評(píng)估了T2WI序列。 2、此次結(jié)果是從臨床實(shí)踐中采集成像數(shù)據(jù)，使用的后處理軟件已在許多研究中被驗(yàn)證。 3、研究對(duì)象為連續(xù)臨床治療病人。 4、本次MR成像技術(shù)遵循了標(biāo)準(zhǔn)化和統(tǒng)一化、排除了在本研究機(jī)構(gòu)之外行乳腺M(fèi)R成像患者，提高了結(jié)果的準(zhǔn)確性 。
本次實(shí)驗(yàn)中的不足
1.本次研究為單中心研究，缺乏對(duì)比。 2.僅在二維圖像上進(jìn)行后處理分析。 3.只研究了T2WI和T 1WI動(dòng)態(tài)增強(qiáng)早期階段。 4.得出的結(jié)論是基于文獻(xiàn)的先驗(yàn)認(rèn)識(shí)。 5.得出的統(tǒng)計(jì)學(xué)結(jié)論僅僅來自測(cè)試人群。
深醫(yī)英文文獻(xiàn)閱讀（06）：血管源性的肝臟腫瘤：影像學(xué)表現(xiàn)
深醫(yī)英文文獻(xiàn)閱讀（05）：比較常規(guī)DWI與DKI對(duì)前列腺癌的檢測(cè)、侵襲性評(píng)估的診斷效能
深醫(yī)英文文獻(xiàn)閱讀（04）：脊髓病變
英文文獻(xiàn)閱讀（03）：血液系統(tǒng)惡性腫瘤的肌骨影像學(xué)表現(xiàn)
英文文獻(xiàn)閱讀（02）：經(jīng)手術(shù)證實(shí)的腸管及腸系膜鈍性損傷的CT表現(xiàn)
英文文獻(xiàn)閱讀（01）：在普通人群中胰腺脂肪變性的MR成像： 臨床相關(guān)性
|
