Analysis of breast cancer extension using new imaging technology, 3-D MRI

使用新成像技术 3-D MRI 分析乳腺癌扩散

• 批准号: 08671328
• 负责人: OHUCHI Noriaki
• 金额: $ 1.34万
• 依托单位: Tohoku University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1996
• 资助国家: 日本
• 起止时间: 1996 至 1997
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08671328/
• 关键词: breast cancer; breast conserving surgery; intraductal spread of carcinoma; magnetic resonance imaging; 3-D mapping; 乳房温存療法:breast conserving therapy; 3次元MRI:3-D MRI; 乳管内進展:intraductal spreading

[Introduction]Now, definition of carcinoma extension becomes more important, as breast conserving therapy is accepted as one of the treatment options. This study was initiated to clarify the ability of magnetic resonance imaging (MRI) in defining the extension of breast carcinoma, in comparison with the pathologic finding created by subserial sectioning of the specimens.[Materials and Methods]Prior to surgery the MRI was performed to 34 patients with breast cancer, then extension of tumors were 3 dimensionally assessed in maximum intensity projection (MIP). Each 3-D MIP was compared to the respective pathologic distribution of carcinoma obtained by subserial mapping.[Results and Discussion]Three imaging patterns were obtained, e.g., 1) localized (n=20), 2) segmental (n=11), and 3) random extensive (n=3) types. Among the specimens classified in localized type, 18 were defined in the TDLU,and intraductal spread of carcinoma to the nipple as long as 4 cm of extension, was observed in 2 specimens. In most of the specimens with segmental type carcinomas distributed along the duct-lobular system from the TDLU to the large duct. Clearly stained tumors in the MRI were histologically revealed to be DCIS which forms solid mass. Three were categorized as random extensive type with linear architecture, and were histologically defined to be carcinomas with diffuse stromal invasion as intraductal spread.Conventional mammography and ultrasonography underestimated carcinoma extension in 6 of the 14 patients who were categorized as segmental, or random extensive type by the MRI,suggesting that the MRI is more appropriate to estimate carcinoma distribution prior to surgery. Ten percent (2/20) of patients with localized type, however, were not visualized in the MRI.Further investigation is required to develop the diagnostic technology in clinical utilization of MRI for breast conserving surgery.

[简介]现在，随着保乳治疗被接受为治疗选择之一，癌症扩散的定义变得更加重要。本研究的目的是澄清磁共振成像（MRI）在定义乳腺癌扩散方面的能力，并与标本连续切片产生的病理结果进行比较。[材料和方法]手术前进行MRI 34 名乳腺癌患者，然后在最大强度投影 (MIP) 中对肿瘤的扩展进行了 3 维评估。将每个 3-D MIP 与通过亚序列映射获得的癌症各自的病理分布进行比较。[结果与讨论]获得三种成像模式，例如 1) 局部 (n=20)、2) 节段性 (n=11)、 3) 随机扩展 (n=3) 类型。在分类为局限性型的标本中，18个标本被定义在TDLU中，并且在2个标本中观察到癌在导管内扩散到乳头长达4厘米。在大多数具有节段型癌的标本中，沿着导管-小叶系统从TDLU到大导管分布。 MRI 中清晰染色的肿瘤在组织学上显示为 DCIS，形成实性肿块。其中 3 例被归类为具有线性结构的随机广泛型，并且在组织学上被定义为具有弥漫性间质浸润（导管内扩散）的癌症。在 14 例被归类为节段性或随机广泛型的患者中，传统乳房 X 光检查和超声检查低估了 6 例的癌症扩展。 MRI，表明 MRI 更适合在手术前估计癌症分布。然而，百分之十 (2/20) 的局限性型患者在 MRI 中无法显现。需要进一步研究开发 MRI 在保乳手术临床应用中的诊断技术。