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基于MRI的模型,用于个性化乳腺癌新辅助治疗

Wen Li¹, Natsuko Onishi¹, Jessica E Gibbs¹

¹Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94158, USA.

Tomography (Ann Arbor, Mich.)

|March 26, 2025

概括

来自MRI的功能瘤体积 (FTV) 准确预测乳腺癌中新辅助化疗 (NAC) 反应. 这种成像生物标志物有助于为治疗反应良好的患者做出早期手术决定.

科学领域:

在瘤学瘤学.
放射学放射学是一门学科.
医疗成像医学成像

背景情况:

动态对比增强MRI的功能瘤体积 (FTV) 是一个关键的成像生物标志物.
在接受新辅助化疗 (NAC) 的乳腺癌患者中,FTV预测了治疗反应.
在一项大型NAC临床试验中,FTV模型为早期手术决策提供了信息.

研究的目的:

使用FTV测量构建预测模型.
分析病理完整反应 (pCR) 预测概率值的性能权衡.
在激素受体/HER2 (HR/HER2) 乳腺癌亚型中开发个别模型.

主要方法:

从I-SPY 2试验 (2010-2016) 中对814名患者的回顾性分析.
在HR/HER2亚型中开发基于FTV的PCR预测模型.
评估概率值以平衡正预测值 (PPV) 和灵敏度.

主要成果:

在ROC曲线下的面积 (AUC) 在亚型中从0.68到0.74不等.
针对PPV的敏感性权衡在不同的概率值 (50%,70%,90%) 上因亚型而异.
在HR-/HER2+和三阴亚型中观察到最高的敏感性;在HR+/HER2-中观察到最低的敏感性.

结论:

像FTV这样的成像生物标志物可以用于预测模型.
临床验证的概率值提高了模型的效用.
这些工具支持乳腺癌治疗的精确瘤学决策.

关键词:

乳腺癌乳腺癌乳腺癌动态对比增强MRI的动态对比增强功能性瘤的体积是功能性瘤的体积.新辅助性化疗是一种新辅助性化疗.病理学的完整反应.治疗决策治疗决策

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