Clinical Study on the Accurate Diagnosis and Treatment of Early Breast Cancer by Combined Multimodal MRI and DBT
Objective:To analyze the value of multimodal magnetic resonance imaging(MRI)combined with digital breast tomosynthesis(DBT)in the accurate diagnosis and treatment of early breast cancer.Method:The clinical data of 117 suspected early breast cancer patients diagnosed in the First Affiliated Hospital of Gannan Medical University from January 2023 to June 2024 were retrospectively analyzed.Both used multimodal MRI and DBT diagnosis,with pathological diagnosis results as the"gold standard".The diagnostic effects(sensitivity,specificity,accuracy,missed diagnosis rate,misdiagnosis rate,positive predictive value,negative predictive value)of multimodal MRI and DBT alone and jointly in the diagnosis of early breast cancer were compared;the differences in multimodal MRI imaging features and multimodal MRI parameters[microvascular density(MVD),peak enhancement rate,and time to peak]between malignant and benign patients were compared.Result:In 117 cases of suspected early breast cancer,pathological results confirmed that 65 cases were positive and 52 cases were negative;62 cases were positive and 55 cases were negative by multimodal MRI diagnose;60 cases were positive and 57 cases were negative by DBT diagnose;73 cases were positive and 44 cases were negative by multimodal MRI combined with DBT diagnose.The diagnostic specificity of multimodal MRI combined with DBT was 80.77%(42/52),and the misdiagnosis rate was 19.23%(10/52),compared with the diagnosis of multimodal MRI alone[80.77%(42/52),19.23%(10/52)],and DBT alone[78.85%(41/52),21.15%(11/52)],the differences were not statistically significant(P>0.05);the sensitivity of multimodal MRI combined with DBT for diagnosis was 96.92%(63/65),and the accuracy was 89.74%(105/117),which were higher than 80.00%(52/65),80.34%(94/117)of modality MRI alone diagnosed,and DBT alone diagnosed[75.38%(49/65),76.92%(90/117)],missed diagnosis rate of 3.08%(2/65),which was lower than those[20.00%(13/65),24.62%(16/65)]of more modality MRI and DBT alone diagnosed,the differences were statistically significant(P<0.05).The positive predictive value of multimodal MRI combined with DBT diagnosis was 86.30%(63/73),which compared with 83.87%(52/62)and 81.67%(49/60)of multimodal MRI and DBT diagnosis alone,the differences were not statistically significant(P>0.05);the negative predictive value of multimodal MRI combined with DBT diagnosis was 95.45%(42/44),which was higher than 76.36%(42/55)and 71.93%(41/57)of multimodal MRI and DBT alone diagnosis,the differences were statistically significant(P<0.05).Compared with benign patients,malignant patients mainly have lesions with a size of≥2 cm,irregular shape,blurred edges,and high density,and the differences were statistically significant(P<0.05).Compared with benign patients,malignant patients MVD and peak enhancement rate were higher,peak time was shorter,the differences were statistically significant(P<0.05).Conclusion:The combination of multimodal MRI and DBT in the diagnosis of early breast cancer can provide richer imaging information and improve diagnostic performance,offering a reference for early clinical diagnosis.
Early breast cancerMultimodal magnetic resonance imagingDigital breast tomosynthesis