Intraoperative Supine Breast MR Imaging to Quantify Tumor Deformation and Detection of Residual Breast Cancer: Preliminary Results
Intraoperative Supine Breast MR Imaging to Quantify Tumor Deformation and Detection of Residual Breast Cancer: Preliminary Results
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DOI：
10.1148/radiol.2016151472
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发表时间：
2016-12-01
期刊：
影响因子：
19.7
通讯作者：
Golshan, Mehra
中科院分区：
文献类型：
--
作者：
Gombos, Eva C.;Jayender, Jagadeesan;Golshan, Mehra
目的：使用术中仰卧位磁共振 (MR) 成像来量化因患者体位从成像（俯卧）到手术（仰卧）改变而继发的乳腺肿瘤变形和移位，并评估保乳手术 (BCS) 后立即残留的肿瘤。材料和方法：15 名女性签署了知情书面同意书，于 2012 年 4 月至 2014 年 11 月期间参与这项符合 HIPAA 要求、机构审查委员会批准的前瞻性研究。12 名患者接受了肿瘤切除术和术后术中仰卧位 MR 成像。 12 名患者中有 6 名接受了术前和术后仰卧位 MR 成像。计算癌症的几何、结构和异质性指标以及肿瘤与乳头、胸壁和皮肤的距离。根据肿瘤模型计算体积、表面积、致密性、球形不比例、球形度和距关键标志的距离变化的平均值和标准偏差。记录成像持续时间。结果：俯卧位和仰卧位成像之间肿瘤变形指标的平均差异如下：体积，23.8%（范围，230%至103.95%）；表面积，6.5%（范围，213.24%至63%）；致密性，16.2%（范围，223%至47.3%）；球形度，6.8%（范围29.10%至20.78%）；球面不比例减少211.3%（范围260.81%至76.95%）。仰卧位图像上的所有肿瘤都比俯卧位图像上更靠近胸壁。手术后获得的 MR 图像上没有看到残留肿瘤的证据。术前和术后仰卧位 MR 成像的平均持续时间分别为 25 分钟（范围，18.4-31.6 分钟）和 19 分钟（范围，15.1-22.9 分钟）。结论：术中仰卧位乳房 MR 成像，当与标准俯卧位乳房 MR 成像结合使用时，能够量化继发于患者从标准成像（俯卧）到手术（仰卧）体位变化的乳腺肿瘤变形和位移，并可能帮助临床医生评估残留情况。 BCS 后立即出现肿瘤。 (C) 北美放射学会，2016
Purpose: To use intraoperative supine magnetic resonance (MR) imaging to quantify breast tumor deformation and displacement secondary to the change in patient positioning from imaging (prone) to surgery (supine) and to evaluate residual tumor immediately after breast-conserving surgery (BCS).Materials and Methods: Fifteen women gave informed written consent to participate in this prospective HIPAA-compliant, institutional review board-approved study between April 2012 and November 2014. Twelve patients underwent lumpectomy and postsurgical intraoperative supine MR imaging. Six of 12 patients underwent both pre- and postsurgical supine MR imaging. Geometric, structural, and heterogeneity metrics of the cancer and distances of the tumor from the nipple, chest wall, and skin were computed. Mean and standard deviations of the changes in volume, surface area, compactness, spherical disproportion, sphericity, and distances from key landmarks were computed from tumor models. Imaging duration was recorded.Results: The mean differences in tumor deformation metrics between prone and supine imaging were as follows: volume, 23.8% (range, 230% to 103.95%); surface area, 6.5% (range, 213.24% to 63%); compactness, 16.2% (range, 223% to 47.3%); sphericity, 6.8% (range, 29.10% to 20.78%); and decrease in spherical disproportion, 211.3% (range, 260.81% to 76.95%). All tumors were closer to the chest wall on supine images than on prone images. No evidence of residual tumor was seen on MR images obtained after the procedures. Mean duration of pre- and postoperative supine MR imaging was 25 minutes (range, 18.4-31.6 minutes) and 19 minutes (range, 15.1-22.9 minutes), respectively.Conclusion: Intraoperative supine breast MR imaging, when performed in conjunction with standard prone breast MR imaging, enables quantification of breast tumor deformation and displacement secondary to changes in patient positioning from standard imaging (prone) to surgery (supine) and may help clinicians evaluate for residual tumor immediately after BCS. (C) RSNA, 2016