Optimized breast MRI functional tumor volume as a biomarker of recurrence-free survival following neoadjuvant chemotherapy.
Optimized breast MRI functional tumor volume as a biomarker of recurrence-free survival following neoadjuvant chemotherapy.
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DOI：
10.1002/jmri.24351
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发表时间：
2014-08
期刊：
影响因子：
--
通讯作者：
Hylton NM
中科院分区：
文献类型：
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作者：
Jafri NF;Newitt DC;Kornak J;Esserman LJ;Joe BN;Hylton NM
目的评价乳腺磁共振成像(MRI)测量功能性肿瘤体积(FTV)的最佳对比动力学阈值，以评估无复发生存率(RFS)。在这项机构审查委员会(IRB)批准的乳腺癌新辅助化疗(NACT)患者(年龄29-72岁，中位年龄48.6岁)的回顾性研究中，所有患者都接受了化疗前和化疗后的MRI1和MRI4检查。肿瘤被定义为满足早期百分比增强阈值(PEThresh)和早晚信号增强比(SERThresh)的体素；通过将所有满足阈值标准和最低连接要求的体素相加，定义为FTV(PEThresh，SERThresh)。评价了PEThresh在50%~220%和SERThresh在0.0~2.0之间的范围。Cox比例风险模型确定了治疗期间FTV的变化与不同PE和SER阈值的RFS之间的关系。风险比从MRI1到MRI4的变化曲线显示出一个宽峰，最大风险比和最大显著值出现在PE阈值为70%和SER阈值为1.0时(风险比=8.71，95%可信区间2.86-25.5，P<；0.00015)，表明模型拟合最优。增强阈值影响MRI肿瘤体积预测RFS的能力。该值在广泛的阈值范围内是稳健的，支持将FTV用作生物标记物。
To evaluate optimal contrast kinetics thresholds for measuring functional tumor volume (FTV) by breast magnetic resonance imaging (MRI) for assessment of recurrence-free survival (RFS). In this Institutional Review Board (IRB)-approved retrospective study of 64 patients (ages 29–72, median age of 48.6) undergoing neoadjuvant chemotherapy (NACT) for breast cancer, all patients underwent pre-MRI1 and postchemotherapy MRI4 of the breast. Tumor was defined as voxels meeting thresholds for early percent enhancement (PEthresh) and early-to-late signal enhancement ratio (SERthresh); and FTV (PEthresh, SERthresh) by summing all voxels meeting threshold criteria and minimum connectivity requirements. Ranges of PEthresh from 50% to 220% and SERthresh from 0.0 to 2.0 were evaluated. A Cox proportional hazard model determined associations between change in FTV over treatment and RFS at different PE and SER thresholds. The plot of hazard ratios for change in FTV from MRI1 to MRI4 showed a broad peak with the maximum hazard ratio and highest significance occurring at PE threshold of 70% and SER threshold of 1.0 (hazard ratio = 8.71, 95% confidence interval 2.86–25.5, P < 0.00015), indicating optimal model fit. Enhancement thresholds affect the ability of MRI tumor volume to predict RFS. The value is robust over a wide range of thresholds, supporting the use of FTV as a biomarker.