Comprehensive analyses with radiological and biological markers of breast cancer on contrast-enhanced chest CT: a single center experience using dual-layer spectral detector CT
Comprehensive analyses with radiological and biological markers of breast cancer on contrast-enhanced chest CT: a single center experience using dual-layer spectral detector CT
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DOI：
10.1007/s00330-019-06615-9
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发表时间：
2020-02-05
影响因子：
5.9
通讯作者：
An, Hyo Jung
中科院分区：
文献类型：
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作者：
Moon, Jin Il;Choi, Bo Hwa;An, Hyo Jung
目的评价虚拟单能成像（VMI）对乳腺癌患者的预测价值，并将其与乳腺癌患者的预后生物标志物进行相关性分析。方法64例患者行动脉期和90 s延迟期双层SDCT扫描。对14例良性肿瘤和65例乳腺癌进行回顾性肿瘤显著性分析，采用常规图像（CI）和40 keV的VMI（VMI 40）动脉和延迟期扫描（CIART，VMI 40（ART），锡德，VMI 40（DE））。在VMI 40（ART）和VMI 40（DE）上测量肿瘤的平均亨氏单位（HU）。进行受试者工作特征（ROC）曲线分析，以比较图像集之间的诊断准确性。使用组织病理学评价雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER 2）和Ki 67水平。分析VMI分析与肿瘤组织学特征的相关性。结果恶性肿瘤在VMI 40上的清晰度评分和平均HU值均显著高于良性肿瘤（P < 0.001）。VMI 40（DE）显示癌症的最高显著性（平均值，3.79）和ROC曲线下面积最大（0.817; 95%置信区间0.745-0.889）。VMI 40（DE）产生的癌症平均HU显著高于VMI 40（ART）（p < 0.001）。在ER阴性、PR阴性和Ki 67阳性的癌症中，VMI 40（ART）上的显著性评分和平均HU显著较高（p < 0.05）。结论VMI 40（DE）对乳腺癌的显示率和增强效果均优于VMI 40（ART），对乳腺癌的诊断有一定的价值。VMI 40（ART）可能有助于预测乳腺癌预后不良。
Objectives To evaluate the predictive value of virtual monoenergetic images (VMIs) by assessing tumor conspicuity on dual-layer spectral detector CT (SDCT) and correlate tumor conspicuity on VMI with prognostic biomarkers in patients with breast cancer. Methods Sixty-four patients underwent arterial phase and 90-s delayed phase dual-layer SDCT. A retrospective tumor conspicuity analysis of 14 benign tumors and 65 breast cancers was performed using conventional images (CIs) and VMI at 40 keV (VMI40) on arterial and delayed phase scans (CIART, VMI40(ART), CIDE, VMI40(DE)). Mean Hounsfield units (HU) of tumors were measured on VMI40(ART) and VMI40(DE). A receiver operating characteristic (ROC) curve analysis was performed to compare diagnostic accuracy between image sets. Estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki67 levels were evaluated using histopathology. Correlations between VMI analyses and histological characteristics of cancers were analyzed. Results Cancers on VMI40 had a significantly higher conspicuity score and mean HU than benign tumors (p < 0.001). VMI40(DE) showed the highest conspicuity for cancers (mean, 3.79) and the greatest area under the ROC curve (0.817; 95% confidence interval 0.745-0.889). VMI40(DE) yielded significantly higher mean HU for cancers than VMI40(ART) (p < 0.001). The conspicuity score and mean HU on VMI40(ART) were significantly higher in cancers with ER negativity, PR negativity, and Ki67 positivity (p < 0.05). Conclusions VMI40(DE) may be useful in the diagnosis of breast cancers due to higher tumor conspicuity and better enhancement than VMI40(ART). VMI40(ART) may be beneficial for the prediction of poor breast cancer prognoses.