在新辅助化疗患者的乳房MRI上评估持久的T1加权病变,而没有同时出现异常增强:对完整的病理反应的影响
Shahine Goulam-Houssein1, Xiang Y Ye2, Rachel Fleming1
1Joint Department of Medical Imaging, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
European radiology
|March 16, 2024
概括
在化疗后的乳腺MRI上,持久的T1权重病变表明乳腺癌患者完全病理反应的可能性较低. 这些发现突出了T1病变作为治疗决策的关键标记.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 病理学 病理学 病理学
背景情况:
- 新辅助化疗是乳腺癌的标准治疗方法.
- 评估治疗反应对于患者管理至关重要.
- 完整的病理反应 (pCR) 是有利结果的关键指标.
研究的目的:
- 为了确定在新辅助化疗后MRI上持续的T1加权病变是否预测乳腺癌的完整病理反应 (pCR).
- 评估持续T1病变与MRI成像反应之间的相关性.
主要方法:
- 2011-2018年间接受新辅助化疗和手术治疗的乳腺癌患者的回顾性评估.
- 纳入标准:前后新辅助化疗乳腺核磁共振,后续手术.
- 统计分析包括千平方,t测试,威尔科克斯等级和逻辑回归来比较组和评估关联.
主要成果:
- 在294名患者中,157名患者在化疗后患有持续的T1病变.
- 持久的T1病变与完全病理反应的显著较低率 (14%对39%,p < 0.001) 和成像反应 (69%对93%,p < 0.001) 相关.
- 多变量分析证实了持续的T1病变作为降低pCR的预测因素 (OR 0.37,95% CI 0.18-0.76,p = 0.007).
结论:
- 在治疗后的乳腺MRI上,持久的T1权重病变与完整的病理和成像反应率相反相关.
- 这些T1病变是重要的临床标志物,应指导后新辅助化疗治疗决策.
- 建议在评估治疗反应时,除了增强外,还应考虑剩余的T1病变.
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