MRI影像组学在乳腺癌诊疗中的研究进展

Overview of MRI-based radiomics in breast cancer

乳腺癌的发病率和死亡率在全球大多数国家女性肿瘤中排名第一,尽管目前在早期发现病灶和及时治疗疾病方面取得了较大进步,但在实现精准医疗方面仍需努力探索。如能对病灶及其周围组织进行精准的定量评估以反映其整体异质性,将有助于为乳腺癌患者制订个性化诊疗方案。影像组学是基于影像图像提取高维数据,通过建立可靠的模型对这些数据进行分析以量化肿瘤异质性,用于疾病的诊断、鉴别诊断及预测,从而提供更多可靠的信息以支持临床决策。影像组学作为目前研究的前沿领域之一,具有较高的临床研究价值。本文将基于MRI图像提取的影像组学特征在鉴别乳腺良恶性肿瘤、区分乳腺癌不同分子亚型,预测腋窝及前哨淋巴结状态、对新辅助化疗的疗效评估及预后预测几方面进行介绍,并阐述当前影像组学发展的前景与局限性,以期改进下一步的研究。

The incidence and mortality of breast cancer ranks first among female tumors in most countries around the world.Although great progress has been made in early detection of lesions and timely treatment of the disease,there is still a gap in the realization of precision medicine and personalized diagnosis and treatment.Efforts are needed to reflect overall heterogeneity of tumors by accurate quantitative assessment of the lesion and its surrounding tissue,which will help to formulate personalized diagnosis and treatment plans for breast cancer patients.Radiomics aims to extract high-dimensional data based on images,and analyze these data by establishing reliable models to quantify tumor heterogeneity for disease diagnosis,differential diagnosis and prediction,thereby providing more reliable evidence to support clinical decision.As one of the frontier fields of current research,radiomics has great clinical research value.In this paper,based on the radiomic features of MRI images,the differentiation of benign and malignant breast tumors,distinction of different molecular subtypes of breast cancer,prediction of axillary and sentinel lymph node status,evaluation of the efficacy of neoadjuvant chemotherapy and prognosis prediction will be introduced.The prospects and limitations of current radiomics development are described to improve future research.