Şüpheli mikrokalsifikasyonda ayırıcı tanıda difüzyon tensör görüntülemenin rolü
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Dosyalar
Tarih
2022
Yazarlar
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Biz bu çalışmada mamografide şüpheli mikrokalsifikasyonları olan lezyonların manyetik rezonans görüntülemedeki difüzyon parametrelerinin benign-malign lezyon ayrımı arasındaki ilişkiyi kantitatif olarak değerlendirmenin etkinliğini araştırdık. Bu çalışma sonucunda difüzyon tensör görüntüleme ile şüpheli mikrokalsifikasyonlarda tanısal ayrım sağlandığı takdirde olgularda gereksiz biyopsinin önüne geçilecektir. Nisan 2016-Ocak 2022 tarihleri arasında, rutin meme manyetik rezonans görüntüleme yanında difüzyon ağırlıklı görüntüleme ve difüzyon tensör sekansları alınan 65 erişkin kadın hasta çalışmamıza dahil edildi. Olguların meme lezyonlarına histopatolojik olarak tanıları koyuldu. Değerlendirmede, mamografi tetkikinde şüpheli mikrokalsifikasyonları bulunan hastalar seçilerek lezyonlar mamografideki kadran özelliklerine ve meme manyetik rezonans görüntülemede şüpheli kontrast tutulumu olan bölgeye karşılık gelen hiperintens alanlardan, özel yazılım aracılığıyla görünür difüzyon katsayısı, fraksiyonel anizotropi, volüm anizotropi değerleri ölçülerek harita görüntüleri hazırlandı. Şüpheli mikrokalsifikasyonlarda difüzyon ağırlıklı görüntülemede görünür difüzyon katsayısı değeri benign lezyonlarda malign lezyonlara göre daha yüksek, fraksiyonel anizotropi ve volümetrik anizotropi değeri daha düşük, difüzyon tensördeki görünür difüzyon katsayısı değeri ise daha yüksek bulunmuştur. Şüpheli mikrokalsifikasyonlarda benign-malign ayrımında eğri altında kalan alanı en fazla olan ve tanısal ayrımda en iyi performans gösteren parametre difüzyon tensördeki görünür difüzyon katsayısı değeri olup; en kötü performans gösteren parametre ise ortalama fraksiyonel anizotropi değeri olarak saptanmıştır. Şüpheli mikrokalsifikasyonlarda benign-malign ayrımında öncül verilere göre difüzyon tensördeki görünür difüzyon katsayısı değeri istatistiksel olarak anlamlı bulunmuş olup (p<0,05) diğer difüzyon tensör parametreleri tanısal ayrımda istatiksel anlamlılık göstermemiştir. İleriki çalışmalarda örneklem büyüklüğünün arttırılmasıyla difüzyon tensör parametrelerinin ayırt ediciliği arttırılabilir. Bununla birlikte güncelde dinamik kontrastlı konvansiyonel manyetik rezonans inceleme meme karsinomu tanısında önemini korumaktadır.
In this study, we investigated the effectiveness of quantitatively evaluating the relationship between benign-malignant lesion differentiation and diffusion parameters in magnetic resonance imaging of lesions with suspicious microcalcifications on mammography. As a result of this study, if diagnostic distinction is provided in suspicious microcalcifications with diffusion tensor imaging, unnecessary biopsy will be prevented in the cases. Between April 2016 and January 2022, 65 adult female patients who underwent routine breast magnetic resonance imaging as well as diffusion-weighted imaging and diffusion tensor sequences were included in our study. The breast lesions of the cases were diagnosed histopathologically. In the evaluation, patients with suspicious microcalcifications in mammography examination were selected and map images were prepared by measuring the apparent diffusion coefficient, fractional anisotropy, and volume anisotropy values from the hyperintense areas corresponding to the quadrant features in mammography and the area with suspicious contrast enhancement in breast magnetic resonance imaging, using special software. In suspicious microcalcifications, the apparent diffusion coefficient value in diffusionweighted imaging was found to be higher in benign lesions than in malignant lesions, the fractional anisotropy and volumetric anisotropy values were lower, and the apparent diffusion coefficient value in the diffusion tensor was higher. The parameter with the highest area under the curve in the differentiation of benignmalignant in suspicious microcalcifications and showing the best performance in the diagnosis is the apparent diffusion coefficient value in the diffusion tensor; the worst performing parameter was determined as the mean fractional anisotropy value. According to the preliminary data, the apparent diffusion coefficient value in the diffusion tensor was found to be statistically significant in the differentiation of benignmalignant in suspicious microcalcifications (p<0.05), while other diffusion tensor parameters did not show statistical significance in the diagnostic distinction. In future studies, the discrimination of diffusion tensor parameters can be increased by increasing the sample size. However, conventional magnetic resonance imaging with dynamic contrast maintains its importance in the diagnosis of breast carcinoma.
In this study, we investigated the effectiveness of quantitatively evaluating the relationship between benign-malignant lesion differentiation and diffusion parameters in magnetic resonance imaging of lesions with suspicious microcalcifications on mammography. As a result of this study, if diagnostic distinction is provided in suspicious microcalcifications with diffusion tensor imaging, unnecessary biopsy will be prevented in the cases. Between April 2016 and January 2022, 65 adult female patients who underwent routine breast magnetic resonance imaging as well as diffusion-weighted imaging and diffusion tensor sequences were included in our study. The breast lesions of the cases were diagnosed histopathologically. In the evaluation, patients with suspicious microcalcifications in mammography examination were selected and map images were prepared by measuring the apparent diffusion coefficient, fractional anisotropy, and volume anisotropy values from the hyperintense areas corresponding to the quadrant features in mammography and the area with suspicious contrast enhancement in breast magnetic resonance imaging, using special software. In suspicious microcalcifications, the apparent diffusion coefficient value in diffusionweighted imaging was found to be higher in benign lesions than in malignant lesions, the fractional anisotropy and volumetric anisotropy values were lower, and the apparent diffusion coefficient value in the diffusion tensor was higher. The parameter with the highest area under the curve in the differentiation of benignmalignant in suspicious microcalcifications and showing the best performance in the diagnosis is the apparent diffusion coefficient value in the diffusion tensor; the worst performing parameter was determined as the mean fractional anisotropy value. According to the preliminary data, the apparent diffusion coefficient value in the diffusion tensor was found to be statistically significant in the differentiation of benignmalignant in suspicious microcalcifications (p<0.05), while other diffusion tensor parameters did not show statistical significance in the diagnostic distinction. In future studies, the discrimination of diffusion tensor parameters can be increased by increasing the sample size. However, conventional magnetic resonance imaging with dynamic contrast maintains its importance in the diagnosis of breast carcinoma.
Açıklama
Anahtar Kelimeler
Meme kanseri, Manyetik rezonans görüntüleme, Difüzyon tensör görüntüleme, Breast cancer, Magnetic resonance imaging, Diffusion tensor imaging
