基于3.0T WBDWIBS的直方图参数评估乳腺癌骨转移疗效的诊断价值初探  

3.0T WBDWIBS with histogram parameters in prediction therapy response of bone metastatic breast cancer:the initial experience

作　　者：耿小川[1,2] 庄治国[1] 张科蓓[1] 陈洁[1] 成芳[1] 张庆[1] 华佳[1] GENG Xiaochuan;ZHUANG Zhiguo;ZHANG Kebei;CHEN Jie;CHENG Fang;ZHANG Qing;HUA Jia(Department of Radiology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China;Department of radiology,Renji Hospital South Campus,Shanghai Jiao Tong University School of Medicine,Shanghai 201112,China)

机构地区：[1]上海交通大学医学院附属仁济医院放射科,上海200127 [2]上海交通大学医学院附属仁济医院南院放射科,上海201112

出　　处：《肿瘤影像学》2020年第3期214-220,共7页Oncoradiology

基　　金：上海交通大学“医工交叉研究基金”重点项目(YG2014ZD05);上海市科学技术委员会高新技术领域重点项目(18511102900,18511102901)。

摘　　要：目的:初步探索3.0T背景抑制全身扩散加权成像(whole-body diffusion-weighted imaging with background body suppression,WBDWIBS)的表观扩散系数(apparent diffusion coefficient,ADC)值直方图参数对于预测乳腺癌骨转移疗效的诊断价值。方法:25例乳腺癌骨转移患者均在治疗前后完善2次WBDWIBS检查,患者疗效评估为疾病进展9例,无疾病进展16例。记录乳腺癌骨转移病灶治疗前后的直方图参数,包括平均值、标准差、偏度、峰度、最小值、10%、25%、中位数、75%、90%、最大值,并计算各个参数的变化率。治疗前后乳腺癌骨转移的ADC值直方图参数比较采用配对样本t检验或Wilcoxon秩和检验。疾病进展与无疾病进展间比较采用两独立样本t检验或Wilcoxon秩和检验。通过受试者工作特征(receiver operating characteristic,ROC)曲线评估直方图参数预测骨转移疗效的诊断效能。结果:25例患者从整体角度分析,治疗后乳腺癌骨转移病灶ADC值的直方图参数中除10%、标准差外均较治疗前有显著变化(P≤0.004)。按照疾病进展和无疾病进展分析,治疗前两组间ADC值的直方图参数值差异无统计学意义(P≥0.193),治疗后ADC值的标准差、10%、25%的值及其变化率两组间差异均有统计学意义(P≤0.024),且具有合理的准确性。结论:基于3.0T的WBDWIBS的ADC值直方图参数对于预测乳腺癌骨转移的疗效具有可行性。Objective:To determine the diagnostic performance of apparent diffusion coefficient(ADC)histogram parameters of 3.0T whole-body diffusion-weighted imaging with background body suppression(WBDWIBS)for predicting response of breast cancer bone metastasis.Methods:For this prospective study,25 study participants with breast cancer bone metastasis underwent WBDWIBS before and after therapy.There were 9 patients with progressive disease.The histogram parameters of breast cancer bone metastases before and after treatment were recorded,including mean,standard deviation,skewness,kurtosis,minimum,10%,25%,median,75%,90%,maximum,and the corresponding rate of change.ADC histogram parameters before and after treatment were compared using paired sample t test or Wilcoxon rank-sum test.Two independent sample t-tests or Wilcoxon rank-sum tests were compared between progressive disease and non-progressive disease.Receiver operating characteristic(ROC)curve was used to determine the performance of ADC histogram parameters for response prediction.Results:On the overall aspect,after therapy,all the histogram parameters except for 10%,standard deviation values were significantly different from those prior to therapy(P≤0.004).On the therapy response aspect,there was no statistical difference between the two groups prior to therapy(P≥0.193).The standard deviation,10%,25%values and corresponding rate of change were statistical different between the two groups(P≤0.024)with reasonable accuracy.Conclusion:The 3.0T WBDWIBS with histogram analysis is favorable for predicting therapy response of breast cancer bone metastasis.

关 键 词：乳腺癌 骨转移 化疗 直方图 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]