扩散加权成像用于提高查乳腺MRI的诊断性能:明显扩散系数量化方法和切断值的影响
Debosmita Biswas1,2, Daniel S Hippe3, Andrea M Winter1
1Department of Radiology, School of Medicine, University of Washington, Seattle, WA, United States.
Frontiers in oncology
|January 6, 2025
概括
在扩散权重MRI (DWI) 中优化明显扩散系数 (ADC) 测量可以减少不必要的乳腺活检. 不同的兴趣区域 (ROI) 方法和ADC切断率产生类似的良性活检减少率,有助于临床决策.
科学领域:
- 放射学和成像学 放射学和成像学
- 在瘤学瘤学.
- 医学诊断 医学诊断 医学诊断
背景情况:
- 扩散加权MRI (DWI) 与明显扩散系数 (ADC) 的测量表明,减少不必要的乳腺活检是有前途的.
- 标准化ADC测量技术和切断值对于高风险查的有效临床整合至关重要.
研究的目的:
- 评估各种损伤ADC测量方法和截止值对乳腺DWI诊断性能的影响.
- 确定在高风险查队列中临床实施最佳DWI方法.
主要方法:
- 查乳腺核磁共振成像检查后期分析有可疑病变的乳腺核磁共振成像检查 (BI-RADS 4或5),需要活检.
- 使用多个b值 (0-800秒/毫米2) 的2D,3D和热点ROI技术计算的ADC指标.
- 使用数据衍生的最佳切线和预规定的切线 (ECOG-ACRIN A6702,EUSOBI) 评估诊断性能.
主要成果:
- 热点ADC指标明显低于二维和三维ROI指标 (p<0.001).
- 在ROI技术中,最佳的ADC切断值实现了可比的良性活检减少 (16.8%-17.8%).
- 预先指定的切断值显示了可变的良性活检减少 (11.2%-51.4%),具有不同的敏感率.
- 使用2或4个b值的ADC测量和活检减少率相似.
结论:
- 在不同的测量方法中,通过适当的ADC值,可以实现良性乳腺活检的可比减少.
- 选择ADC切断值时,应考虑ROI方法和生物检查减少和灵敏度之间的理想平衡.
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