Fan Liu, Lei Wu, Xinyi Luo, Sisi Li, Yishi Wang, Wen Zhong, Thorsten Feiweier, Junzhong Xu, Diwei Shi, Haihua Bao, Hua Guo
{"title":"磁共振细胞术鉴别乳腺良恶性肿瘤的诊断价值评价。","authors":"Fan Liu, Lei Wu, Xinyi Luo, Sisi Li, Yishi Wang, Wen Zhong, Thorsten Feiweier, Junzhong Xu, Diwei Shi, Haihua Bao, Hua Guo","doi":"10.1002/jmri.29757","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>MR cytometry is a class of diffusion-MRI-based methods that characterize tumor microstructures at the cellular level. It involves multicompartmental biophysical modeling of multi-b and multiple diffusion time data to generate microstructural parameters, which may improve differentiation of benign and malignant breast tumors.</p><p><strong>Purpose: </strong>To implement MR cytometry imaging with transcytolemmal water exchange (JOINT and EXCHANGE) to differentiate benign and malignant breast tumors, and to compare the classification efficacy of IMPULSED, JOINT, and EXCHANGE.</p><p><strong>Study type: </strong>Prospective.</p><p><strong>Subjects: </strong>115 patients with pathologically confirmed breast tumors (25 benign and 90 malignant).</p><p><strong>Field strength/sequence: </strong>3T; pulsed gradient spin-echo (PGSE) diffusion-weighted imaging (DWI) and oscillating gradient spin-echo (OGSE) DWI at 25 and 50 Hz.</p><p><strong>Assessment: </strong>Tumor regions were delineated by two radiologists on DWI. Time-dependent ADC and microstructural parameters (cell diameter <math> <semantics><mrow><mi>d</mi></mrow> <annotation>$$ d $$</annotation></semantics> </math> , intracellular volume fraction <math> <semantics> <mrow><msub><mi>v</mi> <mtext>in</mtext></msub> </mrow> <annotation>$$ {v}_{\\mathrm{in}} $$</annotation></semantics> </math> , water exchange rate constant <math> <semantics> <mrow><msub><mi>k</mi> <mtext>in</mtext></msub> </mrow> <annotation>$$ {k}_{\\mathrm{in}} $$</annotation></semantics> </math> , extracellular diffusivity <math> <semantics> <mrow><msub><mi>D</mi> <mi>ex</mi></msub> </mrow> <annotation>$$ {D}_{\\mathrm{ex}} $$</annotation></semantics> </math> and intracellular intrinsic diffusivity <math> <semantics> <mrow><msub><mi>D</mi> <mtext>in</mtext></msub> </mrow> <annotation>$$ {D}_{\\mathrm{in}} $$</annotation></semantics> </math> ) were calculated. Classification performance was assessed in the original cohort and in an age-adjusted cohort (excluding older malignant patients to eliminate significant age differences).</p><p><strong>Statistical tests: </strong>Mann-Whitney U-tests compared benign and malignant tumor values. Multivariable logistic regression used a stepwise approach based on the likelihood ratio test. The area under the receiver operating characteristic (AUC) was computed and compared by using the DeLong test.</p><p><strong>Results: </strong>In the full analysis (25 benign, 90 malignant), microstructural parameters from methods incorporating transcytolemmal water exchange (JOINT and EXCHANGE) demonstrated superior performance (AUC: ADC, 0.822; IMPULSED, 0.840; JOINT, 0.902; EXCHANGE, 0.905). Combining different metrics further improved classification (AUC: IMPULSED [ <math> <semantics><mrow><mi>d</mi></mrow> <annotation>$$ d $$</annotation></semantics> </math> , <math> <semantics> <mrow><msub><mi>v</mi> <mtext>in</mtext></msub> </mrow> <annotation>$$ {v}_{\\mathrm{in}} $$</annotation></semantics> </math> ], 0.942; JOINT [ <math> <semantics><mrow><mi>d</mi></mrow> <annotation>$$ d $$</annotation></semantics> </math> , <math> <semantics> <mrow><msub><mi>v</mi> <mtext>in</mtext></msub> </mrow> <annotation>$$ {v}_{\\mathrm{in}} $$</annotation></semantics> </math> ], 0.956; EXCHANGE [ <math> <semantics><mrow><mi>d</mi></mrow> <annotation>$$ d $$</annotation></semantics> </math> , <math> <semantics> <mrow><msub><mi>k</mi> <mtext>in</mtext></msub> </mrow> <annotation>$$ {k}_{\\mathrm{in}} $$</annotation></semantics> </math> ], 0.954; [ <math> <semantics> <mrow><msub><mi>ADC</mi> <mtext>PGSE</mtext></msub> <mo>,</mo> <msub><mi>ADC</mi> <mrow><mn>25</mn> <mi>Hz</mi></mrow> </msub> <mo>,</mo> <mi>AD</mi> <msub><mi>C</mi> <mrow><mn>50</mn> <mi>Hz</mi></mrow> </msub> </mrow> <annotation>$$ {\\mathrm{ADC}}_{\\mathrm{PGSE}},{\\mathrm{ADC}}_{25\\mathrm{Hz}},\\mathrm{AD}{\\mathrm{C}}_{50\\mathrm{Hz}} $$</annotation></semantics> </math> ], 0.927). These improvements were also observed in the age-adjusted analysis (25 benign, 42 malignant).</p><p><strong>Data conclusion: </strong>MR cytometry outperformed ADC in distinguishing benign and malignant breast tumors. Incorporating transcytolemmal water exchange into biophysical modeling further improved its diagnostic performance.</p><p><strong>Evidence level: </strong>1 Technical Efficacy: Stage 2.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluating the Diagnostic Performance of MR Cytometry Imaging in Differentiating Benign and Malignant Breast Tumors.\",\"authors\":\"Fan Liu, Lei Wu, Xinyi Luo, Sisi Li, Yishi Wang, Wen Zhong, Thorsten Feiweier, Junzhong Xu, Diwei Shi, Haihua Bao, Hua Guo\",\"doi\":\"10.1002/jmri.29757\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>MR cytometry is a class of diffusion-MRI-based methods that characterize tumor microstructures at the cellular level. It involves multicompartmental biophysical modeling of multi-b and multiple diffusion time data to generate microstructural parameters, which may improve differentiation of benign and malignant breast tumors.</p><p><strong>Purpose: </strong>To implement MR cytometry imaging with transcytolemmal water exchange (JOINT and EXCHANGE) to differentiate benign and malignant breast tumors, and to compare the classification efficacy of IMPULSED, JOINT, and EXCHANGE.</p><p><strong>Study type: </strong>Prospective.</p><p><strong>Subjects: </strong>115 patients with pathologically confirmed breast tumors (25 benign and 90 malignant).</p><p><strong>Field strength/sequence: </strong>3T; pulsed gradient spin-echo (PGSE) diffusion-weighted imaging (DWI) and oscillating gradient spin-echo (OGSE) DWI at 25 and 50 Hz.</p><p><strong>Assessment: </strong>Tumor regions were delineated by two radiologists on DWI. Time-dependent ADC and microstructural parameters (cell diameter <math> <semantics><mrow><mi>d</mi></mrow> <annotation>$$ d $$</annotation></semantics> </math> , intracellular volume fraction <math> <semantics> <mrow><msub><mi>v</mi> <mtext>in</mtext></msub> </mrow> <annotation>$$ {v}_{\\\\mathrm{in}} $$</annotation></semantics> </math> , water exchange rate constant <math> <semantics> <mrow><msub><mi>k</mi> <mtext>in</mtext></msub> </mrow> <annotation>$$ {k}_{\\\\mathrm{in}} $$</annotation></semantics> </math> , extracellular diffusivity <math> <semantics> <mrow><msub><mi>D</mi> <mi>ex</mi></msub> </mrow> <annotation>$$ {D}_{\\\\mathrm{ex}} $$</annotation></semantics> </math> and intracellular intrinsic diffusivity <math> <semantics> <mrow><msub><mi>D</mi> <mtext>in</mtext></msub> </mrow> <annotation>$$ {D}_{\\\\mathrm{in}} $$</annotation></semantics> </math> ) were calculated. Classification performance was assessed in the original cohort and in an age-adjusted cohort (excluding older malignant patients to eliminate significant age differences).</p><p><strong>Statistical tests: </strong>Mann-Whitney U-tests compared benign and malignant tumor values. Multivariable logistic regression used a stepwise approach based on the likelihood ratio test. The area under the receiver operating characteristic (AUC) was computed and compared by using the DeLong test.</p><p><strong>Results: </strong>In the full analysis (25 benign, 90 malignant), microstructural parameters from methods incorporating transcytolemmal water exchange (JOINT and EXCHANGE) demonstrated superior performance (AUC: ADC, 0.822; IMPULSED, 0.840; JOINT, 0.902; EXCHANGE, 0.905). Combining different metrics further improved classification (AUC: IMPULSED [ <math> <semantics><mrow><mi>d</mi></mrow> <annotation>$$ d $$</annotation></semantics> </math> , <math> <semantics> <mrow><msub><mi>v</mi> <mtext>in</mtext></msub> </mrow> <annotation>$$ {v}_{\\\\mathrm{in}} $$</annotation></semantics> </math> ], 0.942; JOINT [ <math> <semantics><mrow><mi>d</mi></mrow> <annotation>$$ d $$</annotation></semantics> </math> , <math> <semantics> <mrow><msub><mi>v</mi> <mtext>in</mtext></msub> </mrow> <annotation>$$ {v}_{\\\\mathrm{in}} $$</annotation></semantics> </math> ], 0.956; EXCHANGE [ <math> <semantics><mrow><mi>d</mi></mrow> <annotation>$$ d $$</annotation></semantics> </math> , <math> <semantics> <mrow><msub><mi>k</mi> <mtext>in</mtext></msub> </mrow> <annotation>$$ {k}_{\\\\mathrm{in}} $$</annotation></semantics> </math> ], 0.954; [ <math> <semantics> <mrow><msub><mi>ADC</mi> <mtext>PGSE</mtext></msub> <mo>,</mo> <msub><mi>ADC</mi> <mrow><mn>25</mn> <mi>Hz</mi></mrow> </msub> <mo>,</mo> <mi>AD</mi> <msub><mi>C</mi> <mrow><mn>50</mn> <mi>Hz</mi></mrow> </msub> </mrow> <annotation>$$ {\\\\mathrm{ADC}}_{\\\\mathrm{PGSE}},{\\\\mathrm{ADC}}_{25\\\\mathrm{Hz}},\\\\mathrm{AD}{\\\\mathrm{C}}_{50\\\\mathrm{Hz}} $$</annotation></semantics> </math> ], 0.927). These improvements were also observed in the age-adjusted analysis (25 benign, 42 malignant).</p><p><strong>Data conclusion: </strong>MR cytometry outperformed ADC in distinguishing benign and malignant breast tumors. Incorporating transcytolemmal water exchange into biophysical modeling further improved its diagnostic performance.</p><p><strong>Evidence level: </strong>1 Technical Efficacy: Stage 2.</p>\",\"PeriodicalId\":16140,\"journal\":{\"name\":\"Journal of Magnetic Resonance Imaging\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-03-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Magnetic Resonance Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jmri.29757\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Magnetic Resonance Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jmri.29757","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
摘要
背景：MR细胞术是一类基于扩散mri的方法，在细胞水平上表征肿瘤微结构。它通过对多个b和多个扩散时间数据进行多室生物物理建模，生成微结构参数，从而提高乳腺肿瘤良恶性的鉴别。目的：应用经细胞间质水交换（JOINT和exchange） MR细胞术鉴别乳腺良恶性肿瘤，比较impulse、JOINT和exchange的分类效果。研究类型：前瞻性。研究对象：115例经病理证实的乳腺肿瘤患者（良性25例，恶性90例）。场强/序列：3T；脉冲梯度自旋回波（PGSE）扩散加权成像（DWI）和振荡梯度自旋回波（OGSE） DWI在25和50 Hz。评估：肿瘤区域由两名放射科医生在DWI上划定。计算随时间变化的ADC和微结构参数（细胞直径d $$ d $$，细胞内体积分数v $$ {v}_{\mathrm{in}} $$，水交换速率常数k $$ {k}_{\mathrm{in}} $$，细胞外扩散率d ex $$ {D}_{\mathrm{ex}} $$和细胞内固有扩散率d $$ {D}_{\mathrm{in}} $$）。在原始队列和年龄调整队列中评估分类表现（排除老年恶性患者以消除显著的年龄差异）。统计检验：Mann-Whitney u检验比较良性和恶性肿瘤值。多变量逻辑回归采用基于似然比检验的逐步方法。采用DeLong试验计算并比较了接收机工作特性下的面积。结果：在完整的分析中（25例良性，90例恶性），采用经细胞内皮水交换（JOINT和exchange）方法的显微结构参数表现出优越的性能(AUC: ADC, 0.822；脉冲，0.840；关节，0.902；Exchange, 0.905)。结合不同指标进一步改进了分类(AUC: impulse [d $$ d $$, v in $$ {v}_{\mathrm{in}} $$], 0.942；JOINT [d $$ d $$, v in $$ {v}_{\mathrm{in}} $$], 0.956；EXCHANGE [d $$ d $$, k in $$ {k}_{\mathrm{in}} $$], 0.954；[ADC PGSE, ADC 25 Hz, ADC 50 Hz $$ {\mathrm{ADC}}_{\mathrm{PGSE}},{\mathrm{ADC}}_{25\mathrm{Hz}},\mathrm{AD}{\mathrm{C}}_{50\mathrm{Hz}} $$], 0.927)。在年龄调整分析中也观察到这些改善（良性25例，恶性42例）。结论：磁共振细胞术在乳腺良恶性肿瘤鉴别方面优于ADC。将经细胞膜水交换纳入生物物理模型进一步提高了其诊断性能。证据等级：1技术功效：2期。
Evaluating the Diagnostic Performance of MR Cytometry Imaging in Differentiating Benign and Malignant Breast Tumors.
Background: MR cytometry is a class of diffusion-MRI-based methods that characterize tumor microstructures at the cellular level. It involves multicompartmental biophysical modeling of multi-b and multiple diffusion time data to generate microstructural parameters, which may improve differentiation of benign and malignant breast tumors.
Purpose: To implement MR cytometry imaging with transcytolemmal water exchange (JOINT and EXCHANGE) to differentiate benign and malignant breast tumors, and to compare the classification efficacy of IMPULSED, JOINT, and EXCHANGE.
Study type: Prospective.
Subjects: 115 patients with pathologically confirmed breast tumors (25 benign and 90 malignant).
Field strength/sequence: 3T; pulsed gradient spin-echo (PGSE) diffusion-weighted imaging (DWI) and oscillating gradient spin-echo (OGSE) DWI at 25 and 50 Hz.
Assessment: Tumor regions were delineated by two radiologists on DWI. Time-dependent ADC and microstructural parameters (cell diameter , intracellular volume fraction , water exchange rate constant , extracellular diffusivity and intracellular intrinsic diffusivity ) were calculated. Classification performance was assessed in the original cohort and in an age-adjusted cohort (excluding older malignant patients to eliminate significant age differences).
Statistical tests: Mann-Whitney U-tests compared benign and malignant tumor values. Multivariable logistic regression used a stepwise approach based on the likelihood ratio test. The area under the receiver operating characteristic (AUC) was computed and compared by using the DeLong test.
Results: In the full analysis (25 benign, 90 malignant), microstructural parameters from methods incorporating transcytolemmal water exchange (JOINT and EXCHANGE) demonstrated superior performance (AUC: ADC, 0.822; IMPULSED, 0.840; JOINT, 0.902; EXCHANGE, 0.905). Combining different metrics further improved classification (AUC: IMPULSED [ , ], 0.942; JOINT [ , ], 0.956; EXCHANGE [ , ], 0.954; [ ], 0.927). These improvements were also observed in the age-adjusted analysis (25 benign, 42 malignant).
Data conclusion: MR cytometry outperformed ADC in distinguishing benign and malignant breast tumors. Incorporating transcytolemmal water exchange into biophysical modeling further improved its diagnostic performance.
期刊介绍：
The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.
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