MRI评估乳腺癌新辅助化疗疗效价值的研究进展

Research progress on MRI in evaluation of the efficacy of neoadjuvant chemotherapy in breast cancer

关键词:  乳腺癌  新辅助化疗  磁共振成像  疗效评估

Key words:  breast cancer  neoadjuvant chemotherapy  magnetic resonance imaging  efficacy evaluation

摘要:

乳腺癌是危及女性健康的主要疾病,新辅助化疗已成为三阴性和人表皮生长因子受体2阳性乳腺癌患者的主要治疗方式之一,可延长患者生存期并改善患者的生存质量。磁共振成像(magnetic resonance imaging, MRI)是目前评估新辅助化疗最有效的方法,动态对比增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging, DCE-MRI)不仅可以精准明确残余病灶大小,还可通过测量血流动力学参数和绘制时间-信号强度曲线(time-signal intensity curve, TIC)图对疗效进行半定量评估,弥散加权成像(diffusion weighted imaging, DWI)技术可通过ADC值变化定量评估肿瘤缓解程度,磁共振波谱(magnetic resonance spectroscopy, MRS)技术可对肿瘤内部代谢变化进行评估。基于MRI的影像组学和深度学习已成为研究乳腺癌新辅助化疗疗效评估的热点。

Abstract:

Neoadjuvant chemotherapy has been used to treat the early-stage triple-negative breast cancer and HER2-positive breast cancers, which can prolong the survival and improve the quality of life of the patient. MRI is the most effective imaging method to evaluate the efficacy of neoadjuvant chemotherapy for breast cancer patients. The dynamic contrast-enhanced MRI(DCE-MRI) can confirm the residual disease more correctly and also can assess it size semi-quantitatively by measuring hemodynamic parameters and generating time-signal intensity curve(TIC). The diffusion weighted imaging(DWI) can assess the variation of ADC value quantitatively to measure the degree of tumor remission, and the magnetic resonance spectroscopy(MRS) can show the internal metabolic changes of the tumors to assess the therapeutic efficacy. At present, MRI-based radiomics and deep learning have become the research hotspot in evaluation of treatment response of the neoadjuvant chemotherapy for breast cancer patients.