3D amide proton transfer-weighted imaging may be useful for diagnosing early-stage breast cancer: a prospective monocentric study

IF 3.7 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Yeqin Li, Yan Zhang, Liwen Tian, Ju Li, Huihua Li, Ximing Wang, Cuiyan Wang
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Abstract

Background

We investigated the value of three-dimensional amide proton transfer-weighted imaging (3D-APTWI) in the diagnosis of early-stage breast cancer (BC) and its correlation with the immunohistochemical characteristics of malignant lesions.

Methods

Seventy-eight women underwent APTWI and dynamic contrast-enhanced (DCE)-MRI. Pathological results were categorized as either benign (n = 43) or malignant (n = 37) lesions. The parameters of APTWI and DCE-MRI were compared between the benign and malignant groups. The diagnostic value of 3D-APTWI was evaluated using the area under the receiver operating characteristic curve (ROC-AUC) to establish a diagnostic threshold. Pearson’s correlation was used to analyze the correlation between the magnetization transfer asymmetry (MTRasym) and immunohistochemical characteristics.

Results

The MTRasym and time-to-peak of malignancies were significantly lower than those of benign lesions (all p < 0.010). The volume transfer constant, rate constant, and wash-in and wash-out rates of malignancies were all significantly greater than those of benign lesions (all p < 0.010). ROC-AUCs of 3D-APTWI, DCE-MRI, and 3D-APTWI+DCE to differential diagnosis between early-stage BC and benign lesions were 0.816, 0.745, and 0.858, respectively. Only the difference between AUCAPT+DCE and AUCDCE was significant (p < 0.010). When a threshold of MTRasym for malignancy for 2.42%, the sensitivity and specificity of 3D-APTWI for BC diagnosis were 86.5% and 67.6%, respectively; MTRasym was modestly positively correlated with pathological grade (r = 0.476, p = 0.003) and Ki-67 (r = 0.419, p = 0.020).

Conclusions

3D-APTWI may be used as a supplementary method for patients with contraindications of DCE-MRI. MTRasym can imply the proliferation activities of early-stage BC.

Relevance statement

3D-APTWI can be an alternative diagnostic method for patients with early-stage BC who are not suitable for contrast injection.

Key points

• 3D-APTWI reflects the changes in the microenvironment of early-stage breast cancer.

• Combined 3D-APTWI is superior to DCE-MRI alone for early-stage breast cancer diagnosis.

• 3D-APTWI improves the diagnostic accuracy of early-stage breast cancer.

Graphical Abstract

Abstract Image

三维酰胺质子转移加权成像可用于诊断早期乳腺癌:一项前瞻性单中心研究
背景我们研究了三维酰胺质子转移加权成像(3D-APTWI)在早期乳腺癌(BC)诊断中的价值及其与恶性病变免疫组化特征的相关性。病理结果分为良性病变(43 例)和恶性病变(37 例)。良性组和恶性组的 APTWI 和 DCE-MRI 参数进行了比较。使用接收者操作特征曲线下面积(ROC-AUC)评估 3D-APTWI 的诊断价值,以确定诊断阈值。结果恶性肿瘤的磁化转移不对称性(MTRasym)和峰值时间显著低于良性病变(均为 p <0.010)。恶性肿瘤的体积转移常数、速率常数、洗入率和洗出率均明显高于良性病变(均 p < 0.010)。3D-APTWI、DCE-MRI 和 3D-APTWI+DCE 鉴别诊断早期 BC 和良性病变的 ROC-AUC 分别为 0.816、0.745 和 0.858。只有 AUCAPT+DCE 和 AUCDCE 之间的差异具有显著性(p < 0.010)。当 MTRasym 的恶性阈值为 2.42% 时,3D-APTWI 对 BC 诊断的敏感性和特异性分别为 86.5% 和 67.6%;MTRasym 与病理分级(r = 0.476,p = 0.003)和 Ki-67 (r = 0.419,p = 0.020)呈轻度正相关。相关性声明3D-APTWI可作为不适合注射造影剂的早期乳腺癌患者的替代诊断方法。关键点-3D-APTWI反映了早期乳腺癌微环境的变化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
European Radiology Experimental
European Radiology Experimental Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
6.70
自引率
2.60%
发文量
56
审稿时长
18 weeks
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