Accuracy of MRI for estimating residual tumor size after neoadjuvant chemotherapy in breast cancer with three-dimensional reconstruction technique / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the accuracy of MRI for estimating residual tumor size after neoadjuvant chemotherapy (NAC) with three-dimensional (3D) reconstruction technique.</p><p><b>METHODS</b>This was a prospective study. The data of 61 patients with pathologically proven solitary invasive ductal carcinoma (IIA-IIIC) who had received 6 to 8 cycles of NAC from July 2010 to August 2013 was analyzed. All the patients were female, aging from 31 to 70 years with a median of 49 years. Breast specimen after surgery was prepared with part-mount sub-serial section, and residual tumors were microscopically outlined, scanned and registered by Photoshop software. The 3D model of pathological and MRI residual tumors was reconstructed with 3D-DOCTOR software. The longest diameter, maximum cross-section area and volume of the residual tumors determined using 3D MRI were compared with 3D pathological findings, and the associations between MRI and pathology were analyzed by Spearman rank correlation and Bland-Altman analysis.</p><p><b>RESULTS</b>The longest diameter, maximum cross-section area and volume of the residual tumors after NAC measured by MRI and pathology was highly correlated (r=0.942, 0.941, 0.903, all P=0.00). MRI appears to underestimate pathology in the longest diameter, maximum cross-section area, but slightly overestimate in volume, and two methods had a good consistence (MD=0.3 cm, 95% CI: -1.43 to 1.9 cm; MD=1.39 cm², 95% CI: -9.55 to 12.34 cm²; MD=-0.433 cm³, 95% CI: -7.065 to 6.199 cm³).</p><p><b>CONCLUSION</b>3D MRI reconstruction after NAC could accurately detects the residual tumors after neoadjuvant chemotherapy, and contribute to select patients who received breast conserving therapy after NAC with tumor downstaging.</p>

Correlations between MRI apparent diffusion coefficient and histological grade and molecular biology of breast invasive ductal carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the correlation between the MRI apparent diffusion coefficient (ADC) value and histological grade and molecular biology of breast invasive ductal carcinoma (IDC).</p><p><b>METHODS</b>This retrospective study included 125 patients with IDC verified by pathology from February 2010 to February 2013. Conventional MRI and diffusion-weighted imaging (DWI) examination were performed using a 3.0T scanner with diffusion factor of 0 and 800 s/mm(2). The region of interest (ROI) was drawn on the largest lesion and/or its two adjacent slices. The ADC value of the whole tumor was calculated as the mean ADC value. The correlation between mean ADCs and histological grade and biological factors was analyzed.</p><p><b>RESULTS</b>The mean ADC of pathological grade I, II and III IDC was (1.152 ± 0.072)×10(-3) mm(2)/s, (1.102 ± 0.101)×10(-3) mm(2)/s, and (1.035 ± 0.107)×10(-3) mm(2)/s, respectively. There was a statistically significant difference among them (P = 0.003). Statistically a significant difference was observed between grade III and I (P = 0.034), grade III and II (P = 0.006), but not between grade I and II (P = 0.741). A significant correlation was observed between ADC value and pathological grade (r = -0.342, P < 0.001). The median ADC values were significantly higher in the ER-negative than in the ER-positive cases [(1.130 ± 0.115)×10(-3) mm(2)/s vs. (1.060 ± 0.089) ×10(-3) mm(2)/s, P < 0.001)], in PR-negative than in PR-positive cases [(1.121 ± 0.106)×10(-3) mm(2)/s vs. (1.055 ± 0.096) ×10(-3) mm(2)/s, P < 0.001)], and in Ki-67-negative than in Ki-67-positive cases [(1.153 ± 0.090)×10(-3) mm(2)/s vs. (1.063 ± 0.101) ×10(-3) mm(2)/s, P < 0.001]. A statistically significant correlation was observed between ADC value and expressions of ER, PR, and Ki-67 (r = -0.311, r = -0.317, r = -0.414, P < 0.001).</p><p><b>CONCLUSION</b>ADC value of breast invasive ductal carcinoma is correlated with histological grade, and expression of ER, PR and Ki-67.</p>

Establishment of nomograms to predict shrinkage modes of primary breast tumor after neoadj uvant chemotherapy / 吉林大学学报(医学版)

Objective To explore the clinical variables associated with the shrinkage modes of primary breast tumor in women after neoadj uvant chemotherapy (NAC ), and to develop a nomogram for predicting non-concentric shrinkage mode(NCSM).Methods Sixty-one women with pathologically proven solitary invasive ductal carcinoma (ⅡA-ⅢC)were recruited. Breast specimen was prepared with PMSS, and residual tumors were microscopically outlined,scanned and registered by Photoshop CS 5 software.The 3D model of residual tumors was reconstructed with 3D-DOCTOR 4.0 software to evaluate the shrinkage mode.17 factors such as age and body mass index and menopausal status were chosen as independent variables,and the clinic-pathologic shrinkage mode was considered as dependent variable. A Logistic regression model was used to construct the nomogram. Results Primary tumor stage,lymph node down-staging, PR and mammographic malignant calcification before NAC were independent predictors of clinic-pathologic shrinkage mode (β:1.538,OR:4.656,95%CI:1.414-15.328,P=0.011;β:1.555,OR:4.735, 95%CI:1.082-20.722,P=0.039;β:-1.707, OR:0.181, 95%CI:0.044-0.741,P = 0.017;β:- 1.405, OR:3.808, 95% CI:0.06 - 0.998,P = 0.048, respectively ). The nomogram predicting the risk of NCSM showed a good concordance index(0.869),and its conformity of mean absolute error was 0.039. Conclusion Based on the clinicopathological findings of primary breast tumor, a nomogram to predict shrinkage modes after NAC in breast carcinoma patients is constructed.The statistical tool is helpful for individually selecting the patients who can be treated with BCT after NAC.

The registration accuracy analysis of different CT-MRI imaging fusion method in brain tumor / 中华放射肿瘤学杂志

Objective To find an effective CT-MRI image fusion protocol in brain tumor by analyzing the registration accuracy of different methods. Methods The simulation CT scan and MRI T1 WI imaging of 10 brain tumor patients obtained with same position were registered by Tris-Axes landmark 、Tris-Axes landmark + manual adjustment、 mutual information and mutual information + manual adjustment method. The clinical tumor volume (CTV) were contoured on both CT and MRI images respectively. The accuracy of image fusion was assessed by the mean distance of five bone markers ( d1-5 ), central position of CTV ( dCTV ) the percentage of CTV overlap ( PCT-MRI ) between CT and MRI images. The difference between different methods was analyzed by Freidman M non-parameter test. Results The difference of the means d1-5 between the Tris-Axes landmark、Tris-Axes landmark plus manual adjustment、mutual information and mutual information plus manual adjustment methods were 0. 28 cm ±0. 12 cm, 0. 15 cm ±0.02 cm, 0. 25 cm± 0. 19 cm, 0. 10 cm ± 0. 06 cm, ( M = 14. 41, P = 0. 002 ). the means dCTV were 0. 59 cm ± 0. 28 cm,0. 60 cm± 0. 32 cm, 0. 58 cm ± 0. 39 cm, 0. 42 cm± 0. 30 cm( M = 9. 72, P = 0. 021 ), the means PCT-MRI were 0.69% ±0. 18%, 0.68% ±0. 16%, 0.66% ±0. 17%, 0.74% ±0. 14% (M = 14.82,P=0.002),respectively. Conclusions Mutual information plus manual adjustment registration method was the preferable fusion method for brain tumor patients.

Design of Universal Bed Board by Immobilizing for Multi-mode Medical Images Fusion / 医疗卫生装备

Objective To design a kind of bed board that is suitable for various medical image diagnostic equipments. It is used to make the body position of the person who is examined to be fixed and can be moved with whom. Methods The bed board is made of low density plastics; its structure is similar to "winnowing fan" in shape. In which, the pipes filled with "multifunction developer" are arranged in order. The negative pressure vacuum bag and belts for the body positioning are installed on the bed board. Volumetric reconstruction has been done with single mode images, then multi- mode images volumetric fusion depend on registration with coronal and arrowy mark of image pipeline in volumetric reconstruction. Results The bed board can not be showed in CT, MRI, PET and SPECT with the soft tissue window, but the pipes be used as the marker for image fusion is displayed clearly. The body position is all the same with each medical image examination. National patent of the product was declared. Conclusion With the designed bed board, the multimode image fusion is rapid, simple and accurate, is easily expansion and popularize.