MR-Guided Near-Infrared Spectral Tomography Increases Diagnostic Performance of Breast MRI.
MR-Guided Near-Infrared Spectral Tomography Increases Diagnostic Performance of Breast MRI.
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DOI：
10.1158/1078-0432.ccr-14-2546
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发表时间：
2015-09-01
期刊：
影响因子：
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通讯作者：
Paulsen KD
中科院分区：
文献类型：
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作者：
Mastanduno MA;Xu J;El-Ghussein F;Jiang S;Yin H;Zhao Y;Wang K;Ren F;Gui J;Pogue BW;Paulsen KD
本研究的目的是确定诊断上最重要的分子生物标志物量化的磁共振引导（MR）近红外光谱断层扫描（NIRST），区分恶性乳腺病变与良性异常时，结合临床乳腺MRI的结果。该研究符合HIPAA，并得到了达特茅斯机构审查委员会、NIH、美国国务院和西京医院的批准。MR引导的NIRST评价了乳房中通过同步动态对比增强MRI（DCE-MRI）定义的感兴趣区域中的血红蛋白、水和脂质含量。在44例受试者中进行了MRI加NIRST（中位年龄46岁，年龄范围20-81岁），其中28例随后有恶性病理诊断，16例有良性疾病。30例受试者的一个子集检查产生的光学数据符合对可疑病变的最低灵敏度要求，并被纳入诊断性能分析。在满足最低光学数据敏感性标准的30名受试者检查子集中，MR引导的NIRST使用总血红蛋白（HbT; P < 0.01）和组织光学指数（TOI; P < 0.001）区分恶性和良性病变。结合MRI加TOI数据导致1个假阳性和1个假阴性，并产生最佳诊断性能，分别产生0.95的AUC、95%的灵敏度、89%的特异性、95%的阳性预测值和89%的阴性预测值。MRI加NIRST结果与组织病理学诊断相关性良好，可提供额外信息以减少MRI引导活检的数量。
The purpose of this study was to determine the diagnostically most important molecular biomarkers quantified by magnetic resonance-guided (MR) near-infrared spectral tomography (NIRST) that distinguish malignant breast lesions from benign abnormalities when combined with outcomes from clinical breast MRI. The study was HIPAA compliant and approved by the Dartmouth Institutional Review Board, the NIH, the United States State Department, and Xijing Hospital. MR-guided NIRST evaluated hemoglobin, water, and lipid content in regions of interest defined by concurrent dynamic contrast-enhanced MRI (DCE-MRI) in the breast. MRI plus NIRST was performed in 44 subjects (median age, 46, age range, 20–81 years), 28 of whom had subsequent malignant pathologic diagnoses, and 16 had benign conditions. A subset of 30 subject examinations yielded optical data that met minimum sensitivity requirements to the suspicious lesion and were included in the analyses of diagnostic performance. In the subset of 30 subject examinations meeting minimum optical data sensitivity criterion, the MR-guided NIRST separated malignant from benign lesions using total hemoglobin (HbT; P < 0.01) and tissue optical index (TOI; P < 0.001). Combined MRI plus TOI data caused one false positive and 1 false negative, and produced the best diagnostic performance, yielding an AUC of 0.95, sensitivity of 95%, specificity of 89%, positive predictive value of 95%, and negative predictive value of 89%, respectively. MRI plus NIRST results correlated well with histopathologic diagnoses and could provide additional information to reduce the number of MRI-directed biopsies.