Intravoxel incoherent motion imaging of tumor microenvironment in locally advanced breast cancer.
Intravoxel incoherent motion imaging of tumor microenvironment in locally advanced breast cancer.
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DOI：
10.1002/mrm.22740
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发表时间：
2011-05
影响因子：
3.3
通讯作者：
Moy L
中科院分区：
文献类型：
--
作者：
Sigmund EE;Cho GY;Kim S;Finn M;Moccaldi M;Jensen JH;Sodickson DK;Goldberg JD;Formenti S;Moy L
弥散加权成像(DWI)在肿瘤诊断、监测和治疗中发挥着重要作用。虽然大多数应用程序通过肿瘤细胞密度来测量受限扩散，但DWI也通过体素内非相干运动(IVIM)效应对血管密度敏感。在乳腺癌中，血管丰富会影响表观弥散系数(ADC)的测量。我们在一组乳腺癌患者中获得了3T的多个b值DWI，并进行了双指数IVIM分析，以提取组织扩散率(DT)、灌注率(FP)和假扩散率(DP)。结果显示，正常纤维腺组织与恶性病变的平均ADC值(±标准差)分别为2.44±0.30vs.1.34±0.39μm2/ms和DT(2.36±0.38vs.1.15±0.35μm2/ms，p<；0.01)。与正常组织相比，病变组织的DWI信号呈现双指数特征。FP(10.5±5.0%比6.9±2.9%，p=0.06)、DT(1.14±0.32μm2/ms比1.18±0.52μm2/ms，p=0.88)和DP(14.9±11.4μm2/ms比16.1±5.7μm2/ms，p=0.75)在病变亚型(浸润性导管癌与其他恶性病变)之间有一定的差异。IVIM生物标记物与对比增强的比较提示有适度的相关性。这些结果表明，IVIM血管和细胞生物标记物在乳腺肿瘤的初始分级、进展监测或治疗评估中具有潜力。
Diffusion-weighted imaging (DWI) plays important roles in cancer diagnosis, monitoring, and treatment. While most applications measure restricted diffusion by tumor cellularity, DWI is also sensitive to vascularity through the intravoxel incoherent motion (IVIM) effect. Hypervascularity can confound apparent diffusion coefficient (ADC) measurements in breast cancer. We acquired multiple b-value DWI at 3 T in a cohort of breast cancer patients and performed biexponential IVIM analysis to extract tissue diffusivity (Dt), perfusion fraction (fp), and pseudodiffusivity (Dp). Results indicated significant differences between normal fibroglandular tissue and malignant lesions in ADC mean (± standard deviation) values (2.44± 0.30 vs. 1.34 ± 0.39 μm2/ms, p < 0.01) and Dt (2.36± 0.38 vs. 1.15 ± 0.35 μm2/ms, p < 0.01). Lesion DWI signals demonstrated biexponential character in comparison to monoexponential normal tissue. There is some differentiation of lesion subtypes (invasive ductal carcinoma (IDC) vs. other (OT) malignant lesions) with fp (10.5 ± 5.0% vs. 6.9 ± 2.9%, p = 0.06), but less so with Dt (1.14±0.32 μm2/ms vs. 1.18 ± 0.52 μm2/ms, p = 0.88), and Dp (14.9 ± 11.4 μm2/ms vs. 16.1 ± 5.7 μm2/ms, p = 0.75). Comparison of IVIM biomarkers with contrast-enhancement suggests moderate correlations. These results suggest the potential of IVIM vascular and cellular biomarkers for initial grading, progression monitoring, or treatment assessment of breast tumors.