Clinical Breast MR Using MRS or DWI: Who Is the Winner?
Clinical Breast MR Using MRS or DWI: Who Is the Winner?
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DOI：
10.3389/fonc.2016.00217
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发表时间：
2016
影响因子：
4.7
通讯作者：
Trimboli RM
中科院分区：
文献类型：
--
作者：
Sardanelli F;Carbonaro LA;Montemezzi S;Cavedon C;Trimboli RM
乳腺磁共振成像（MRI）由于对比增强（CE）协议的最佳灵敏度而在临床实践中发挥作用。这种方法，首次提出30年前，并进一步发展为双边高空间分辨率的动态研究，目前被认为是上级癌症检测的任何其他技术。然而，已经探索了CE成像以外的其他方向。除了非增强T2加权图像上的形态特征外，主要在体内运行两种不同的非对比分子方法：质子磁共振波谱（1H-MRS）和扩散加权成像（DWI）。这两种方法都显示了CE-MRI隐藏的乳腺癌（BC）方面：1H-MRS允许评估总胆碱峰（tCho）作为恶性肿瘤的生物标志物; DWI显示限制扩散率与高细胞性和肿瘤侵袭性相关。关于这两种方法的次要证据现在可从系统综述和荟萃分析中获得，本文主要考虑：1H-MRS和DWI的合并灵敏度范围分别为71-74%和84-91%;特异性分别为78-88%和75- 84%。有趣的研究前景是开放的，这两种技术，包括多体素MRS和统计策略的分类MR频谱，以及扩散张量成像和体素内非相干运动的DWI。然而，从临床角度来看，虽然MRS仍然是一种具有重要局限性的研究工具，例如相对较长的采集时间，频繁的低质量光谱，难以标准化和定量tCho组织浓度，但DWI已被整合到乳腺MRI的标准临床方案中，并且几项研究显示其作为BC检测的独立方法的潜在价值。
Magnetic resonance imaging (MRI) of the breast gained a role in clinical practice thanks to the optimal sensitivity of contrast-enhanced (CE) protocols. This approach, first proposed 30 years ago and further developed as bilateral highly spatially resolved dynamic study, is currently considered superior for cancer detection to any other technique. However, other directions than CE imaging have been explored. Apart from morphologic features on unenhanced T2-weighted images, two different non-contrast molecular approaches were mainly run in vivo: proton MR spectroscopy (1H-MRS) and diffusion-weighted imaging (DWI). Both approaches have shown aspects of breast cancer (BC) hidden to CE-MRI: 1H-MRS allowed for evaluating the total choline peak (tCho) as a biomarker of malignancy; DWI showed that restricted diffusivity is correlated with high cellularity and tumor aggressiveness. Secondary evidence on the two approaches is now available from systematic reviews and meta-analyses, mainly considered in this article: pooled sensitivity ranged 71–74% for 1H-MRS and 84–91% for DWI; specificity 78–88% and 75–84%, respectively. Interesting research perspectives are opened for both techniques, including multivoxel MRS and statistical strategies for classification of MR spectra as well as diffusion tensor imaging and intravoxel incoherent motion for DWI. However, when looking at a clinical perspective, while MRS remained a research tool with important limitations, such as relatively long acquisition times, frequent low quality spectra, difficult standardization, and quantification of tCho tissue concentration, DWI has been integrated in the standard clinical protocols of breast MRI and several studies showed its potential value as a stand-alone approach for BC detection.
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DOI：
10.1002/jmri.24929
发表时间：
2015-12
期刊：
Journal of magnetic resonance imaging : JMRI
影响因子：
--
作者：
Barentsz MW;Taviani V;Chang JM;Ikeda DM;Miyake KK;Banerjee S;van den Bosch MA;Hargreaves BA;Daniel BL
通讯作者：
Daniel BL
定量弥散加权磁共振成像在乳腺病变鉴别诊断中的Meta分析
影响因子：
3.8
作者：
Chen X;Li WL;Zhang YL;Wu Q;Guo YM;Bai ZL
通讯作者：
Bai ZL
影响因子：
8.9
作者：
Fausto, A.;Magaldi, A.;Sardanelli, F.
通讯作者：
Sardanelli, F.
影响因子：
5.9
作者：
Baltzer, Pascal A. T.;Benndorf, Matthias;Kaiser, Werner A.
通讯作者：
Kaiser, Werner A.
影响因子：
1.3
作者：
Dietzel, Matthias;Baltzer, Pascal A. T.;Kaiser, Werner A.
通讯作者：
Kaiser, Werner A.