Dedicated Breast CT: Feasibility for Monitoring Neoadjuvant Chemotherapy Treatment.
Dedicated Breast CT: Feasibility for Monitoring Neoadjuvant Chemotherapy Treatment.
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DOI：
10.4103/2156-7514.145867
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发表时间：
2014
影响因子：
0.9
通讯作者：
Skinner KA
中科院分区：
文献类型：
--
作者：
Vedantham S;O'Connell AM;Shi L;Karellas A;Huston AJ;Skinner KA
在这项前瞻性的初步研究中，研究了非造影剂专用乳腺计算机断层扫描（bCT）在新辅助化疗（NAC）治疗期间确定原发肿瘤体积并监测其变化的可行性。11名接受NAC的妇女在治疗前、治疗中和治疗后三个时间点使用临床原型专用bCT系统进行成像。研究放射科医师标记原发肿瘤的边界，由此量化肿瘤体积。开发了一种自动算法来量化原发肿瘤体积，以便与放射科医生的分割进行比较。确定治疗前bCT与MRI肿瘤体积的相关性，以及治疗后bCT与病理肿瘤大小的相关性和一致性。自动分割的肿瘤体积和放射科医生分割的肿瘤体积是相关的（Pearson’s r = 0.935, P < 0.001），并且在所有时间点上没有差异[P = 0.808，重复测量方差分析（ANOVA）]。治疗前MRI与bCT的肿瘤体积相关（r = 0.905, P < 0.001）。大于5 mm的浸润性导管癌，治疗后bCT肿瘤大小与病理相关（r = 0.987, P = 0.002），肿瘤大小最大差异为0.57 cm。活检夹（3mm）的存在限制了准确测量小于5mm肿瘤的能力。所有的研究参与者都被病理评估为反应者，其中三名受试者经历了侵袭性癌症的完全病理反应，而提示者经历了部分反应。与治疗前相比，bCT治疗中期肿瘤体积缩小有统计学意义（P = 0.0003，配对t检验），平均肿瘤体积缩小47%。这项初步研究表明，专用的非对比bCT有可能作为一种权宜的成像工具，用于监测NAC期间肿瘤体积的变化。未来还需要更大规模的研究。
In this prospective pilot study, the feasibility of non-contrast dedicated breast computed tomography (bCT) to determine primary tumor volume and monitor its changes during neoadjuvant chemotherapy (NAC) treatment was investigated. Eleven women who underwent NAC were imaged with a clinical prototype dedicated bCT system at three time points – pre-, mid-, and post-treatment. The study radiologist marked the boundary of the primary tumor from which the tumor volume was quantified. An automated algorithm was developed to quantify the primary tumor volume for comparison with radiologist's segmentation. The correlation between pre-treatment tumor volumes from bCT and MRI, and the correlation and concordance in tumor size between post-treatment bCT and pathology were determined. Tumor volumes from automated and radiologist's segmentations were correlated (Pearson's r = 0.935, P < 0.001) and were not different over all time points [P = 0.808, repeated measures analysis of variance (ANOVA)]. Pre-treatment tumor volumes from MRI and bCT were correlated (r = 0.905, P < 0.001). Tumor size from post-treatment bCT was correlated with pathology (r = 0.987, P = 0.002) for invasive ductal carcinoma larger than 5 mm and the maximum difference in tumor size was 0.57 cm. The presence of biopsy clip (3 mm) limited the ability to accurately measure tumors smaller than 5 mm. All study participants were pathologically assessed to be responders, with three subjects experiencing complete pathologic response for invasive cancer and the reminder experiencing partial response. Compared to pre-treatment tumor volume, there was a statistically significant (P = 0.0003, paired t-test) reduction in tumor volume at mid-treatment observed with bCT, with an average tumor volume reduction of 47%. This pilot study suggests that dedicated non-contrast bCT has the potential to serve as an expedient imaging tool for monitoring tumor volume changes during NAC. Larger studies are needed in future.