解释对比成像来规划乳腺手术
Donna B Taylor1,2,3, Max M Hobbs1, Maxine Mariri Ronald4
1Department of Diagnostic and Interventional Radiology, Royal Perth Hospital, Perth, Western Australia, Australia.
在常规成像 (CI) 中添加对比增强性乳腺造影 (CEM) 和磁共振成像 (MRI) 可以改变乳腺癌手术计划. 然而,这些变化需要仔细评估,以防止潜在的过度或不足治疗.
科学领域:
- 乳腺癌成像和手术规划.
- 放射学和瘤外科手术的决策.
背景情况:
- 对比增强性乳腺造影 (CEM) 和磁共振成像 (MRI) 为乳腺癌的分期提供了比传统成像 (CI) 更高的准确性.
- 将CEM和MRI整合到乳腺癌手术规划中的影响仍未得到充分研究.
研究的目的:
- 研究如何将CEM或MRI添加到常规成像 (CI) 影响乳腺癌手术计划.
- 评估通过对比成像修改的手术计划的适当性.
主要方法:
- 模拟多学科团队 (MDTs) 根据CI,CI+CEM和CI+MRI设计了手术计划 (BCS,更广泛的BCS,>1BCS,乳腺切除术).
- 分析了计划中的差异,并根据最终的病理学评估了适当性.
- 手术结果与模拟MDT计划进行了比较.
主要成果:
- 在32.8%的病例中,对比成像改变了手术计划 (20/61).
- 在修改的案例中,CEM在80% (16/20) 和MRI在85% (17/20) 的案例中改变了计划.
- 修改计划的适当性各不相同,CI+CEM计划在37.5%的案例中适用,CI+MRI计划在52.9%的案例中适用.
结论:
- 将CEM或MRI添加到CI可以改变三分之一的乳腺癌患者的手术计划.
- 修改后的手术计划需要仔细验证,因为并非所有变化都是适当的.
- 改变基于对比成像而没有活检确认的手术计划可能会导致过度治疗或治疗不足.
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