Addition of T2-guided optical tomography improves noncontrast breast magnetic resonance imaging diagnosis
Addition of T2-guided optical tomography improves noncontrast breast magnetic resonance imaging diagnosis
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DOI：
10.1186/s13058-017-0902-x
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发表时间：
2017-10-24
影响因子：
7.4
通讯作者：
Paulsen, Keith D.
中科院分区：
文献类型：
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作者：
Feng, Jinchao;Xu, Junqing;Paulsen, Keith D.
背景资料：虽然动态对比增强磁共振成像（DCE MRI）被认为是乳腺癌检测的最敏感检查，但它具有相当大的假阳性率，并且钆（Gd）造影剂的耐受性并不普遍。因此，基于内源性造影剂诊断乳腺癌的替代方案越来越受到关注。在这项研究中，内源性近红外光谱断层扫描（NIRST）的T2 MRI引导下进行了评估，以探讨是否联合成像方式，它不需要造影剂注射或涉及电离辐射，可以达到可接受的诊断performance.Methods：24名受试者-16例病理证实的恶性肿瘤和8例良性异常-同时成像与MRI和NIRST明确的病理诊断之前。MRI由三名对病理结果不知情的乳腺放射科医生独立评估。在T2 MRI中，光学图像重建受到灰度值的限制。MRI和NIRST图像被单独或组合使用，以估计数据的诊断性能。将结果与DCE结果进行比较。当与T2引导的NIRST联合使用时，非对比MRI的灵敏度、特异性、准确性和曲线下面积（AUC）分别为94%、100%、96%和0.95，而单独使用DCE MRI时，这些值分别为94%、63%、88%和0.81，而单独使用DCE MRI时，这些值分别为88%、88%、88%和0.95。结论：在这项研究中，当T2引导的NIRST单独加入非造影MRI时，成像诊断的总体准确性提高到96%，而DCE MRI为88%，这表明无需造影剂即可达到相似或更好的诊断准确性。
Background: While dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) is recognized as the most sensitive examination for breast cancer detection, it has a substantial false positive rate and gadolinium (Gd) contrast agents are not universally well tolerated. As a result, alternatives to diagnosing breast cancer based on endogenous contrast are of growing interest. In this study, endogenous near-infrared spectral tomography (NIRST) guided by T2 MRI was evaluated to explore whether the combined imaging modality, which does not require contrast injection or involve ionizing radiation, can achieve acceptable diagnostic performance.Methods: Twenty-four subjects-16 with pathologically confirmed malignancy and 8 with benign abnormalities-were simultaneously imaged with MRI and NIRST prior to definitive pathological diagnosis. MRIs were evaluated independently by three breast radiologists blinded to the pathological results. Optical image reconstructions were constrained by grayscale values in the T2 MRI. MRI and NIRST images were used, alone and in combination, to estimate the diagnostic performance of the data. Outcomes were compared to DCE results.Results: Sensitivity, specificity, accuracy, and area under the curve (AUC) of noncontrast MRI when combined with T2-guided NIRST were 94%, 100%, 96%, and 0.95, respectively, whereas these values were 94%, 63%, 88%, and 0.81 for DCE MRI alone, and 88%, 88%, 88%, and 0.94 when DCE-guided NIRST was added.Conclusion: In this study, the overall accuracy of imaging diagnosis improved to 96% when T2-guided NIRST was added to noncontrast MRI alone, relative to 88% for DCE MRI, suggesting that similar or better diagnostic accuracy can be achieved without requiring a contrast agent.