Breast Cancer Heterogeneity: MR Imaging Texture Analysis and Survival Outcomes
Breast Cancer Heterogeneity: MR Imaging Texture Analysis and Survival Outcomes
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DOI：
10.1148/radiol.2016160261
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发表时间：
2017-03-01
期刊：
影响因子：
19.7
通讯作者：
Nam, Seok Jin
中科院分区：
文献类型：
--
作者：
Kim, Jae-Hun;Ko, Eun Sook;Nam, Seok Jin
目的：探讨磁共振成像纹理分析评价乳腺癌患者的肿瘤异质性与预后的关系。材料与方法：2010年1月至8月，对203例乳腺癌患者行T2加权及对比剂增强T1加权减影磁共振成像。计算了基于直方图的均匀度和熵。为了将纹理参数二分法用于生存分析，采用10次交叉验证法确定受试者工作特征曲线分析的截止点。应用COX比例风险模型和Kaplan-Meier分析，分析MRI图像或临床病理变量获得的纹理参数和形态或体积信息与无复发生存率(RFS)的关系。结果：共发生26起事件，其中复发22例(局部复发10例，远处复发12例)，死亡4例，平均随访时间56.2个月。在多变量分析中，较高的N期(RFS危险比，11.15[N3期]；P=0.002，Bonferroni调整后的α=.0167)，三重阴性亚型(RFS危险比，16.91；P<；.001，Bonferroni调整后的Alpha=.0167)，T1的高风险(小于截止值[平均值，5.057；范围，5.022-5.167]，RFS危险比，4.55；P=.018)，以及T2熵(等于或高于截止值[平均值，6.013；结论：乳腺癌患者在T2加权像上表现出较高的不均一性(较高的熵)和在对比度增强的T1加权减影像上表现出较少的不均质性(较低的熵)的乳腺癌患者的RFS较差。(C)RSNA，2016年
Purpose: To determine the relationship between tumor heterogeneity assessed by means of magnetic resonance (MR) imaging texture analysis and survival outcomes in patients with primary breast cancer.Materials and Methods: Between January and August 2010, texture analysis of the entire primary breast tumor in 203 patients was performed with T2-weighted and contrast material-enhanced T1-weighted subtraction MR imaging for preoperative staging. Histogram-based uniformity and entropy were calculated. To dichotomize texture parameters for survival analysis, the 10-fold cross-validation method was used to determine cutoff points in the receiver operating characteristic curve analysis. The Cox proportional hazards model and Kaplan-Meier analysis were used to determine the association of texture parameters and morphologic or volumetric information obtained at MR imaging or clinical-pathologic variables with recurrence-free survival (RFS).Results: There were 26 events, including 22 recurrences (10 local-regional and 12 distant) and four deaths, with a mean follow-up time of 56.2 months. In multivariate analysis, a higher N stage (RFS hazard ratio, 11.15 [N3 stage]; P = .002, Bonferroni-adjusted alpha = .0167), triple-negative subtype (RFS hazard ratio, 16.91; P < .001, Bonferroni-adjusted alpha = .0167), high risk of T1 entropy (less than the cutoff values [mean, 5.057; range, 5.022-5.167], RFS hazard ratio, 4.55; P = .018), and T2 entropy (equal to or higher than the cutoff values [mean, 6.013; range, 6.004-6.035], RFS hazard ratio = 9.84; P = .001) were associated with worse outcomes.Conclusion: Patients with breast cancers that appeared more heterogeneous on T2-weighted images (higher entropy) and those that appeared less heterogeneous on contrast-enhanced T1-weighted subtraction images (lower entropy) exhibited poorer RFS. (C) RSNA, 2016