CDT-VIBE序列DCE-MRI:血流动力学参数与乳腺癌预后因子的相关性

Correlation of pharmacokinetic parameters with prognostic factors of breast cancers:a retrospective study in dynamic contrast-enhanced MRI with CAIPIRINHA-Dixon-TWIST-VIBE technique

目的:基于CAIPIRINHA-Dixon-TWIST-VIBE(CDT-VIBE)序列高分辨率动态增强磁共振成像(DCE-MRI),分析乳腺癌血流动力学参数与预后因子的相关性。方法:对96例经组织病理证实为浸润性乳腺癌的患者,采用容积内插屏气扫描(CDT-VIBE)序列结合超快速并行采集(CAIPIRINHA)、水-脂分离(Dixon)及时间分辨交叉随机轨迹成像(TWIST)三种技术进行3.0TDCEMRI检查,共采集35期图像(空间分辨率为1.0mm×1.0mm×1.5mm,每期扫描时间11.24s)。测量所有病灶的血流动力学参数(Ktrans、Kep、Ve)。对乳腺肿瘤的病理标本进行免疫组化检查,获得雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体(Her-2)和Ki-67的值。采用t检验比较乳腺癌ER、PR、HER-2和Ki-67不同表达状态间DCE-MRI定量参数的差异。结果:PR阴性组(n=28)和PR阳性组(n=42)的Ktrans值(0.40±0.16vs 0.32±0.11)min-1和Kep值(0.96±0.26vs 0.81±0.26)min-1的差异有统计学意义(P<0.05);两组间Ve值的差异无统计学意义(P>0.05)。Ki-67低表达组(n=22)和高表达组(n=48)的Ktrans(0.39±0.14vs 0.27±0.11)min-1、Kep(0.93±0.26vs0.76±0.27)min-1和Ve(0.44±0.11vs 0.38±0.10)值的组间差异均有统计学意义(P<0.05)。各定量参数在ER和Her-2不同表达状态之间的差异无统计学意义(P>0.05)。结论:乳腺癌的高分辨率DCE-MRI定量参数值与预后因子(PR、Ki-67)之间具有一定的相关性,提示其在乳腺癌的个体化治疗中具有潜在的应用价值。

Objective:To investigate the correlation between prognostic factors and hemodynamic parameters of breast cancer using dynamic contrast-enhanced MRI(DCE-MRI)based on CAIPIRINHA-Dixon-TWIST-VIBE(CDT-VIBE)technique.Methods:A total of 96 patients with invasive ductal carcinoma(DCIS)confirmed by histopathology were enrolled in this study with their informed consent.All patients underwent breast DCE-MRI using a prototype CDT-VIBE sequence at a 3.0T MR scanner,35 phases was scanned with acquisition time of 11.24s in each phase and spatial resolution of 1.0mm×1.0mm×1.5mm.Hemodynamic parameters of breast leions including volume transfer constant between extracellular extravascular space(EES)and plasma(K trans),constant flux rate between EES and plasma(K ep)and EES volume per unit volume of tissue(Ve)were then calculated using the functional Tissue 4D software.The prognostic factors including estrogen receptor(ER),progesterone receptor(PR),Ki-67,human epidermal growth factor receptor 2(HER-2)were obtained from histopathological reports.Single-sample K-S test and paired t-test with Bonferroni correction were used for statistical analysis.Results:K^trans and K ep values were higher in PR-negative tumors(n=28)than those in PR-positive tumors(n=42)with statistically significant difference(0.40±0.16 vs 0.32±0.11,0.96±0.26 vs 0.81±0.26;both P<0.05).However,no significant difference of V e values was showed between PR-negative and PR-positive tumors.K^trans,Kep and Ve values in Ki-67 negative tumors(n=22)were lower when compared to Ki-67 positive tumors(n=48)with statistically significant difference(0.39±0.14 vs 0.27±0.11,0.93±0.26 vs 0.76±0.27,0.44±0.11 vs 0.38±0.10;all P<0.05).The other prognostic factors(ER and HER-2)showed no significant difference in quantitative parameters(Ktrans,Kep,Ve)between positive and negative group.Conclusion:Significant correlations exists between quantitative parameters(Ktrans,Kep)of high spatial and temporal resolution DCE-MRI and prognostic factors(PR,Ki-67)in breast cancers.These imaging tools may provide a non-invasive method for evaluating the efficacy of neoadjuvant therapy.