Meme kanseri moleküler alt tiplerinin MR görüntüleme özellikleri
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Date
2020
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Hatay Mustafa Kemal Üniversitesi
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info:eu-repo/semantics/openAccess
Abstract
Amaç: Çalışmamızda meme kanserinin önemli bir prognostik belirleyicisi olan moleküler alt tiplerinin manyetik rezonans (MR) görüntüleme özelliklerinin araştırılması amaçlandı. Gereç ve Yöntem: Patoloji sonucuna göre meme kanseri tanısı bulunan 104 hastanın preoperatif MR tetkikleri 5.Baskı Breast Imaging-Reporting and Data System (BI-RADS) atlasına retrospektif olarak incelendi. BI-RADS'a göre olgular kitle veya kitlesel olmayan kontrastlanma olarak ayrıldı. Olguların arka plan parankim kontrastlanmaları değerlendirildi. Kitlelerin şekil, kontur, kontrastlanma özellikleri; kitlesel olmayan kontrastlanmaların ise dağılım ve internal kontrastlanma paternleri ve tüm olguların kinetik özellikleri,ADC değerleri, multifokal/multisentrik (MFMS) olma durumları, lezyonlara eşlik eden bulgular incelendi. Moleküler alt tipler ile MR bulguları istatiksel olarak Kruskal Wallis testi ve ki-kare testleri kullanılarak araştırıldı. Bulgular: Moleküler alt tipler ile kitle/ kitlesel olmayan kontrastlanma olma arasındaki ilişki istatiksel olarak anlamlı bulundu (p=0,017). En yüksek kitlesel olmayan kontrastlanma oranına (%70) sahip alt tip HER-2 (+)'ti. Kitlelerin şekil (p=0,001) ve kontur (p=0,002) özelliklerinin moleküler alt tiplere göre farklılık gösterdiği izlendi; Luminal tiplerin daha çok düzensiz şekilli ve düzensiz/spiküle konturlu; HER-2 ve Triple(-) alt tiplerin ise daha çok oval/yuvarlak şekilli ve düzgün konturlu olduğu dikkati çekti. Aksiller lenfadenopati en sık (%64.3) Triple (-) alt tipinde izlendi (p=0,033). Hızlı kontrastlanma oranı en yüksek olan (%71.4) alt tip Triple (-) olup erken faz kinetik eğrileri ile alt tipler arasında anlamlı ilişki bulundu (p=0,048). Sonuç: Bu çalışmada moleküler alt tipler ile birçok MR bulgusu arasında anlamlı ilişki bulunmuş olup daha geniş olgu serilerinde, prospektif olarak yapılacak ileriki çalışmalar bu konudaki bilgi birikimimizi arttıracaktır.
Aim: In our study, it was aimed to investigate the magnetic resonance (MR) imaging properties of molecular subtypes, that are an important prognostic marker of breast cancer. Material and method: Preoperative MR examinations of 104 patients, diagnosed with breast cancer according to pathology report, were retrospectively reviewed according to the 5th Edition of Breast Imaging-Reporting and Data System (BI-RADS) atlas. According to BI-RADS, cases were divided into mass or non-mass enhancement. Background parenchymal enhancement of cases were examined. Shape, margin and contrast features of mass enhancements and distribution and internal contrast patterns of non-mass enhancements were examined; finally multifocal/ multicentric (MFMS) status, ADC values, kinetic curves and findings accompanying lesions were examined in all cases. Molecular subtypes and MRI findings were compared by using chi-square and kruskal-wallis tests. Results: The relationship between molecular subtypes and mass/ non-mass enhancement was statistically significant (p=0,017). The subtype with the highest non-mass contrast (enhancement) ratio (%70) was HER-2 (+). It was observed that the shape (p = 0.001) and margin (p = 0.002) features of the masses differed according to molecular subtypes. It was noted that luminal types are mostly irregularly shaped and irregular / spicular margin; HER-2 and Triple (-) subtypes are mostly oval / round shaped and smooth margin. Axillary lymphadenopathy was most commonly (%64.3) observed in Triple (-) subtype (p = 0.033). The subtype with the fastest enhancement ratio (%71.4) was Triple (-). A significant relation was found between early phase kinetic curves and subtypes (p=0,048). Conclusion: In this study, a significant relationship was found between molecular subtypes and many MRI findings, and prospective studies in larger case series will increase our knowledge on this subject.
Aim: In our study, it was aimed to investigate the magnetic resonance (MR) imaging properties of molecular subtypes, that are an important prognostic marker of breast cancer. Material and method: Preoperative MR examinations of 104 patients, diagnosed with breast cancer according to pathology report, were retrospectively reviewed according to the 5th Edition of Breast Imaging-Reporting and Data System (BI-RADS) atlas. According to BI-RADS, cases were divided into mass or non-mass enhancement. Background parenchymal enhancement of cases were examined. Shape, margin and contrast features of mass enhancements and distribution and internal contrast patterns of non-mass enhancements were examined; finally multifocal/ multicentric (MFMS) status, ADC values, kinetic curves and findings accompanying lesions were examined in all cases. Molecular subtypes and MRI findings were compared by using chi-square and kruskal-wallis tests. Results: The relationship between molecular subtypes and mass/ non-mass enhancement was statistically significant (p=0,017). The subtype with the highest non-mass contrast (enhancement) ratio (%70) was HER-2 (+). It was observed that the shape (p = 0.001) and margin (p = 0.002) features of the masses differed according to molecular subtypes. It was noted that luminal types are mostly irregularly shaped and irregular / spicular margin; HER-2 and Triple (-) subtypes are mostly oval / round shaped and smooth margin. Axillary lymphadenopathy was most commonly (%64.3) observed in Triple (-) subtype (p = 0.033). The subtype with the fastest enhancement ratio (%71.4) was Triple (-). A significant relation was found between early phase kinetic curves and subtypes (p=0,048). Conclusion: In this study, a significant relationship was found between molecular subtypes and many MRI findings, and prospective studies in larger case series will increase our knowledge on this subject.
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Keywords
Radyoloji ve Nükleer Tıp, Radiology and Nuclear Medicine, BI-RADS, meme kanseri, manyetik rezonans, moleküler alt tip, MRG, BI-RADS, breast cancer, magnetic resonance, molecular subtype, MRI
