Value of Voxel Incoherent Motion Imaging Combined with Dynamic Contrast-enhanced MRI in Evaluating Recurrence of Breast Cancer After Modified Radical Mastectomy
Objective To explore the value of voxel incoherent motion imaging(IVIM)combined with dynamic contrast enhanced-magnetic resonance imaging(DCE-MRI)in evaluating the recurrence of breast cancer after modified radical mastecto-my.Methods A prospective cohort study was conducted to select breast cancer patients who planned to undergo modified radical mastectomy.All patients were examined by IVIM and DCE-MRI before operation.The IVIM parameters[pure water molecular dif-fusion coefficient(D value),perfusion fraction(f value),pseudo-diffusion coefficient(D*value)]and DCE-MRI quantitative pa-rameters[volume transfer constant(Ktrans),extravascular extracellular volume fraction(Ve),rate constant(Kep)]were detec-ted.Modified radical mastectomy was performed for breast cancer.The patients were followed up for 1 year.The recurrence of pa-tients during the follow-up period was counted.The relationship between preoperative IVIM combined with DCE-MRI parameters and postoperative recurrence in breast cancer patients was analyzed.At the same time,the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of preoperative IVIM combined with DCE-MRI parameters for postoperative recur-rence of breast cancer patients.Results A total of 105 patients with breast cancer were included.After 1 year follow-up,34 cases recurred,accounting for 32.38％.Preoperative Ktrans and Kep in the recurrence group were higher than the non recurrence group,and Ve was lower than those in the non recurrence group,with statistical significant differences(P＜0.05).The preopera-tive D value of patients in the recurrence group was lower than that in the non recurrence group,while the f value and D*value were higher than those in the non recurrence group,with statistical significant differences(P＜0.05).By point binary correlation analysis,the preoperative Ktrans,Kep,f value,D*value were positively correlated with postoperative recurrence of breast cancer patients(γ＞0,P＜0.05).Ve and D values were negatively correlated with postoperative recurrence of breast cancer(γ＜0,P＜0.05).The results of drawing Receiver operating characteristic showed that Ktrans,Ve,Kep,D value,f value,D*value predicted the AUC of postoperative recurrence of breast cancer patients was＞0.7 alone,and the AUC of joint prediction was＞0.9,with a higher predictive value.Conclusion Preoperative IVIM and DCE-MRI examination have important evaluation value for the recur-rence of breast cancer patients after modified radical mastectomy.IVIM parameters combined with DCE-MRI quantitative parame-ters can be used as an effective predictor of the recurrence of breast cancer patients after modified radical mastectomy.
NETL
NSTL
万方数据
