TherelationshipbetweentheimagingresultsbasedonADCvalueandtheefficacy ofneoadjuvantchemotherapyinbreastcancer / 实用放射学杂志

Objective TodiscusstheevaluationeffectivenessofADCofMR DWIinneoadjuvantchemotherapy (NAC).Methods ThirtyGninepatientswithlocallyadvancedbreastcancerwereenrolledinthisstudy.Allthesepatientswerediagnosedbypuncture biopsyandtreatedwithNAC.DWIwasperformedbeforechemotherapyandafter4cyclesofchemotherapyrespectively.Radicalresectionof breastcancerwasperformedwithinoneweekaftertheendof4cyclesofNAC.Accordingtotheclinicalefficacyorpathologicalresponse,the changesoftumorvolumeandtumorcelldensitybeforeandafterchemotherapyweremeasured.Theresponseoftumorwasdividedas clinicallyeffective,completeremission (CR)+partialremission(PR)andclinicalineffectiveness,stabilizationdisease(SD)+progression disease(PD)ormajorhistologicalresponse (MHR)andnonGmajorhistologicalresponse (NMHR),respectively.Toevaluatethe practicalutilityofneoadjuvantchemotherapy,theADCvaluesweremeasuredinallgroupsandanalyzedstatistically.Results Before NAC,therewasnosignificantdifferenceinADCvaluebetweenCR+PR (0.96±0.22)andSD+PD (0.93±0.14)orMHR (1.05±0.22), NMHR (0.99±0.14).TheratiosofCR+PRand MHR were56.4%and66.7%respectivelyattheendoftreatment,andtheADC valuesinallpatientswerehigherthanthatbeforechemotherapy.However,Therewasnosignificantdifferencebeforeandafterchemotherapy intheSD+PD (1.02±0.19)andNMHR (1.08±0.20)groups (P＞0.05),whileCR+PR (1.47±0.16)and MHR (1.62+0.13) groupsweresignificantlydifferentbeforeandafterchemotherapy(P＜0.05).Therateoftumorvolumechangewaspositivelycorrelated withΔADC (r＝0.539,P＜0.05).Conclusion TheADCvalue canbeusedtoevaluatethevolumeandpathologicalgradeof tumorafterNACbasedon MRIplainscananddynamicscan, whichishelpfulfortimelyandeffectivepredictiveevaluationof chemotherapyeffect.ADCvaluecanbeusedasearlyevaluationofNACforbreastcancerandprognosticindicators.

Thestudyofapparentdiffusioncoefficientinmolecularsubtypeofnonmassenhancedbreastcancer / 实用放射学杂志

Objective ToevaluatevaluesofADCofDWIinmolecularsubtypeofnonmassenhancedbreastcancerandprovidereference forclinicaltherapeuticplan.Methods Nonmassenhancedbreastcancerincluding46casesofductalcarcinomainsitu(DCIS)and58 casesofinvasiveductalcancer(IDC)wereprovedbyhistopathologyandexperiencedMRIofroutinesequence,DWIanddynamicenhancement.All thepatientsweredividedintobothgroups,DCISgroupandIDCgroup.Accordingtoimmunohistochemicalcharacteristic,molecularsubytpes,Luminal A,LuminalBandnon-Luminalwerefurthergroupedineachgroup.TheADCvaluesoflesionsweremeasuredonADCmapsofb=0s/mm2and b=800s/mm2.TheADCvaluesofnormalbreastgland,DCISandIDC,ofmolecularsubtypeinternaleachgroup,ofsamemolecular subtypebetweengroupswerestatisticallycomparedI.fthedatahadmarkeddifference,ROCcurveofADCvaluesweredrewfortestingtheefficacy diagnosis.Results TheROImeasuredwere104positionsinnormalglands,86inDCISand115inIDCinwhichtheADCwererespectively (1.77±0.27)mm2/s,(1.08±0.14)mm2/sand (0.89±0.15)mm2/sthathadstatisticaldifference.TheADCvaluesofLuminalA, LuminalBandnon-LuminalinDCISwererespectively(11.1±01.5)mm2/s,(1.04±0.13)mm2/sand(1.04±0.13)mm2/sthathadn’tstatistical difference.TheADCvaluesofLuminalA,LuminalBandnon-LuminalinIDCwererespectively(0.95±0.19)mm2/s,(0.87±0.13)mm2/sand (0.84±0.15)mm2/sthathadstatisticaldifference.TheADCvalueshadstatisticaldifferenceinsame molecularsubtypebetween DCISandIDC.InanalysisofROCofIDC,AUCofADCvalueswererespectively0.561,0.632and0.520,theirsensitivity>81%,but specificitywaslower.Conclusion TheADCvaluesofIDCinLuminalA wasmarkedhigherthanLuminalBandADCvaluesofnon-Luminalwaslowest.TheADCvaluesofLuminalA,LuminalBandnon-LuminalinDCISwerehigherthancorrespondingmolecular subtypeofIDCthatmeansADCvaluescouldindicatemolecular subtypeinformationofbreastcancerandprovidereferencefor clinicaltherapeuticplan.

QuantitativeDCE-MRIparameterscombinedwithADCvalueforevaluationof histopathologicalgradeinpatientswithinvasiveductalbreastcancer / 实用放射学杂志

Objective ToinvestigatethecorrelationandthediagnosticefficiencyofquantitativeDCE-MRIparametersandADC valueinhistopathologicalgradeinpatients withinvasiveductalbreastcancer.Methods The DCE-MRIquantitativeparameters (Ktrans,KepandVe),semiquantitativeparameters(W-in,W-outandTTP)andtheADCvaluewereanalyzedandcomparedaccording bydifferenthistopathologicalgradein90invasiveductalbreastcancerpatients.Results ThemeanvalueofKtrans washigheringradeⅢgroupthanthatingradeⅡgroup,andthemeanvalueofADCwasloweringradeⅢgroupthanthatingradeⅡgroup.Thedifferenceswere statisticallysignificant(P<0.05),butthecorrelationswereweak(|r|<0.30).TherewerenostatisticallysignificantdifferencesamongKep, Ve,W-in,W-out,TTPingradeⅡandgradeⅢ (P>0.05).TheAUCofKtrans,ADCandKtranscombinedwithADCwere0.647,0.685 and0.749,respectively.Conclusion TheDCE-MRIquantitativeparametersKtransandADCvaluehavecorrelationswithhistopathologicalgradeof invasiveductalbreastcancer.HigherKtransandlowerADCvalueindicatehigherhistologicalgrade,andKtranscombinedwithADCcould improvethediagnosticefficiency.

ThevalueofdiffusionGweighted MRinthedifferentialdiagnosisofovarianepithelialtumors / 实用放射学杂志

Objective ToinvestigatethevalueofDWIinthedifferentialdiagnosisofmalignantovarianepithelialtumorsfrombenign ovarianepithelialtumors.Methods MRimagesof34patientswithovarianepithelialtumorsconfirmedbypathologywereanalyzed retrospectively.ThemeanADCvaluesofthesolidpartsofthetumorsweremeasured,comparedandanalyzedstatisticallybetweenthe benignandmalignantovarianepithelialtumors.Results ThesignalintensityofsolidpartsonDWIwassignificantlyhigherinmalignant ovarianepithelialtumorsthanthatinbenignovarianepithelialtumors(P＜0.05).Whenthebvaluewassetas0s/mm2,400s/mm2, 600s/mm2and800s/mm2,thesolidcomponentsofbenignovarianepithelialtumorsdidnotshowrestricteddiffusion,with mean ADCvalueof (1.52±0.65)×10－3 mm2/s.Restricteddiffusionswereobservedinthesolidpartsofmalignantovarianepithelial tumors,withmeanADCvalueof(0.98±0.28)×10－3 mm2/s.TheADCvaluesofsolidpartsweresignificantlylowerinmalignantovarian epithelialtumorsandthedifferencewasstatisticallysignificantbetweenthemalignantandbenigntumors(P＜0.05).Conclusion The signalintensityofsolidpartsonDWIissignificantlyhigherinmalignantovarianepithelialtumorsthanthatinbenignovarianepithelial tumors,buttheADCvaluesareopposite.DWIcanbeusedtodifferentiatebenignfrom malignantovarianepithelialtumors.