治疗后的MRI可以预测三阴性乳腺癌对新辅助化疗免疫疗法的病理完整反应
Toulsie Ramtohul1, Derek Lollivier1, Justine Spriet2
1Department of Radiology, Institut Curie, PSL Research University, 26 rue d'Ulm, Paris 75005, France.
治疗后MRI显示完整反应准确地预测新辅助化疗免疫治疗后早期三阴性乳腺癌的病理完整反应. 这种成像工具有助于评估TNBC患者的治疗有效性.
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:
- 新辅助化疗免疫疗法 (NACI) 显著改善了早期三阴性乳腺癌 (TNBC) 的结果.
- 治疗后MRI对NACI后TNBC病理完整反应 (pCR) 的预测准确性尚未得到充分确立.
研究的目的:
- 评估治疗后MRI在预测NACI接受的TNBC患者的pCR方面的表现.
主要方法:
- 未来的多中心研究涉及早期TNBC患者.
- 对NACI后的动态对比增强MRI扫描进行分析.
- 评估了放射性完整反应 (rCR) 和放射性特征,以预测pCR.
- 使用多变量逻辑回归和外部验证.
主要成果:
- 在MRI上,放射性完整反应 (rCR) 显示了pCR的强有力的预测值 (AUC 0.83).
- 一个组合模型 (rCR + 节点状态 + Ki-67) 在测试组中实现了0.88的AUC.
- 在特定的子组中,rCR的错误发现率很低 (3.5-3.6%).
- 对非rCR病例的基于放射学模型的研究表明AUC为0.80.
结论:
- 在MRI上的治疗后rCR是NACI后早期TNBC中pCR的高效预测器.
- 对治疗反应的成像评估可以指导TNBC的临床决策.
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