RESUMEN

PURPOSE: To evaluate the relationship between kinetic parameters of ultrafast dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) and tumor-infiltrating lymphocytes (TILs) in breast cancer. PATIENTS AND METHODS: This retrospective study was approved by an institutional review board and included 76 women (median age: 60) with 76 surgically proven breast cancers who underwent DCE MRI including ultrafast sequence. Based on the TILs level, we classified the patients into the low-TILs (< 10%) group and the high-TILs (≥ 10%) group. Maximum slope (MS) and time to enhancement (TTE) derived from ultrafast DCE sequence were correlated in each TILs group. The percentages of six kinetic patterns (fast, medium, and slow from the early phase, washout, plateau, and persistent from the delayed phase) derived from the conventional DCE sequence were also correlated in each TILs group. RESULTS: Of the 76 breast cancers, 57 were in the low-TILs group and 19 comprised the high-TILs group. The median MS in the high-TILs group (32.4%/sec) was significantly higher than that in the low-TILs group (23.68%/s) (p = 0.037). In a receiver-operating characteristic (ROC) analysis, the area under the curve (AUC) for differentiating between the high- and low-TILs group was 0.661. The TTE in the high-TILs group was significantly shorter than that in the low-TILs group (p = 0.012). In the ROC analysis, the AUC was 0.685. There were no significant differences between the percentages of the six kinetic patterns from the conventional DCE sequence and the TILs level (p = 0.075-0.876). CONCLUSION: Compared to the low-TILs group, the high-TILs group had higher MS and shorter TTE.

RESUMEN

PURPOSE: To assess the dependency of the Time to enhancement (TTE) of breast lesions and normal breast parenchyma from menopausal status and menstrual cycle using ultrafast compressed sensing (CS) -accelerated dynamic contrast-enhanced (DCE) MRI. METHODS: This institutional review board approved retrospective study included 89 breast cancers, 22 benign lesions and 131 normal breast parenchymal foci. A prototypical ultrafast DCE sequence obtained 30 phases with 2.9 s temporal resolution. Mean and median TTE of all breast cancers, benign lesions and normal breast parenchymal foci were assessed. we also assessed whether there were any differences in TTE regarding the menopausal status and menstrual cycle. RESULTS: The TTE of breast cancer was significantly shorter than that of benign lesions and normal breast parenchymal foci in both the premenopausal status (5.8 vs. 8.7 and 8.7 s, respectively) (p = 0.0028 and < 0.0001, respectively) and postmenopausal status (5.8 vs. 11.6 and 11.6 s, respectively) (p < 0.0001 in both). The TTE of parenchymal foci in the premenopausal status was significantly shorter than that in the postmenopausal status (p = 0.0025). Although the TTE interval between cancer and parenchymal foci in premenopausal status is shorter than that in postmenopausal status, the AUCs in the pre- and postmenopausal status for differentiating breast cancer and parenchymal foci were comparable with using different cutoff TTE values. There were no differences in TTE regarding the menstrual cycle. CONCLUSIONS: The TTE derived from ultrafast CS-accelerated DCE MRI was useful to differentiate breast cancer from benign lesions and normal breast parenchymal foci in both pre- and postmenopausal status.

Asunto(s)

RESUMEN

The principal concept of the percutaneous tandem drainage procedure for an intractable hepaticojejunostomy (HJ) leakage is to decrease the amount of fluid and divide the fluid-filled cavity into several small cavities, which can then be drained individually. Percutaneous abscess drainage (PAD) has a role in drainage of the fluid cavity, whereas percutaneous trans-anastomotic jejunum drainage (PTAJD) has a role in drainage to reduce the bile fluid and digestive juices. A decrease in fluid induces effective drainage of the fluid cavity by PAD. A negative pressure suction drain accelerates reduction of the fluid cavity. PAD is removed when the localized fluid cavity has collapsed. PTAJD is finally removed after a clamping test is performed. Since 2020, we performed the percutaneous tandem drainage for two patients, and an intractable HJ leakage was gently resolved within 3 months without any adverse event. The percutaneous tandem drainage technique is safe for steady drain management of an intractable HJ leakage.

Asunto(s)

RESUMEN

OBJECTIVE: Purpose of our study is to assess the relationship between MRI findings and invasive breast cancer (IBC) with cancer-associated fibroblasts (CAFs) that are positive for podoplanin. METHODS: We retrospectively analyzed the consecutive 109 IBCs. The IBCs were dichotomized as with (+) or without (-) podoplanin-positive CAFs. In MRI analyses, the dichotomized IBCs were compared the lesion to muscle ratio (L/M ratio) in STIR images, the ADC value, the distribution of kinetic parameters, and morphological findings. RESULTS: Of the 109 IBCs, 28 (26%) IBCs had podoplanin(+) CAFs. Compared to the podoplanin(-) group, the podoplanin(+) group tended to have a more malignant pathological status. In the STIR images, the podoplanin(+) group had significantly higher L/M ratio (7.59 vs. 6.55, p = 0.040). In a dynamic study, the podoplanin(+) group had a significantly higher percentage of the washout pattern (42.21% vs. 29.43%, p = 0.045). There were 23 mass lesions and 5 non-mass enhancement (NME) lesions in the podoplanin(+) group, and 69 mass lesions and 12 NME lesions in the podoplanin(-) group. The mass lesions of the podoplanin(-) group had a significantly higher likelihood of showing an irregular shape (n = 47 vs. 8, p = 0.035). The podoplanin(+) group's lesions had a significantly higher likelihood of showing a circumscribed margin (n = 14 vs. 6, p < 0.001) and a rim enhancement (n = 10 vs. 13, p = 0.047). In multivariate analyses, only high nuclear grade was significant predictive value of podoplanin(+) CAFs. CONCLUSION: Although not significant in multivariate analyses, MRI findings may be used to determine the podoplanin-positive CAF status of invasive breast cancer.

Asunto(s)

RESUMEN

PURPOSE: To determine the relationship between the maximum slope (MS) of ultrafast dynamic contrast-enhanced (DCE)-MRI and prognostic factors of breast cancer. METHODS: One hundred thirteen patients with 118 breast cancers were included in this study. The ultrafast DCE sequence was acquired using a higher parallel imaging factor. Its spatial resolution was 0.9 × 0.9 × 2.5 mm and its temporal resolution was 8.3 s/phase. Each lesion was automatically segmented, and the ROI of highest enhancement in the lesion was identified. In this ROI, the MS was calculated. The MS of each lesion was compared with various prognostic factors of breast cancer. RESULTS: The MS of invasive cancer (median: 9.81%/sec) was significantly higher than that of ductal carcinoma in situ (median: 7.26%/sec) (p = 0.001). In the ROC analysis, the area under the ROC curve (AUC) was 0.7295. The MS of invasive cancer with axillary lymph node (LN) metastasis (median: 11.97%/sec) was significantly higher than that without axillary LN metastasis (median: 9.425%/sec) (p = 0.0024). In the ROC analysis, the AUC was 0.7177. In addition, the MS became significantly higher as the level of the proliferation marker ki-67 increased (correlation coefficient: 0.3317) (p = 0.0009). CONCLUSIONS: MS of ultrafast DCE-MRI is useful for predicting the prognostic factors of breast cancer. Higher maximum slope (MS) is significantly associated with an invasive breast cancer component. Higher MS is significantly associated with an axillary lymph node metastasis. MS becomes significantly higher with increasing ki-67 (a proliferation marker). Ultrafast MRI is useful for predicting the prognostic factors of breast cancer.

Asunto(s)

RESUMEN

OBJECTIVE: To correlate the tumor-stromal ratio (TSR) of invasive breast cancer and MRI findings. METHODS: This study was approved by our institutional review board. 126 consecutive patients with surgically proven invasive breast cancer were included. All patients underwent MRI exams including short-tau inversion-recovery (STIR) T 2 weighted imaging, diffusion-weighted imaging (DWI) and post-contrast dynamic imaging. The mean signal intensity (SI) and apparent diffusion coefficient (ADC) value of each lesion were measured. To objectively evaluate the STIR images, the ratio of the SI of the lesion to the muscle (L/M ratio) was also measured. Percentages of MRI kinetic parameters obtained from dynamic images were also measured. The TSR was defined as the percentage of the stromal component, and categorized into high-stroma (> 50%) and low-stroma (< 50%) groups. Intergroup differences in the SI, L/M ratio, ADC value and percentages of kinetic parameters were examined. RESULTS: The SI and L/M ratio of the high-stroma group were significantly lower than those of the low-stromal group (208.64 vs 331.86 for SI, 5.69 vs 9.31 for L/M ratio) (p < 0.001). The high-stroma group had significantly lower percentages of a washout pattern (25% vs 34.7 %) (p = 0.012) and significantly higher percentages of a persistent pattern (36.92% vs 28.26 %) (p = 0.044). There were no significant correlations between the TSR and ADC value. CONCLUSION: STIR and dynamic sequence of breast MRI reflects the stromal component of invasive breast cancer. ADVANCES IN KNOWLEDGE: This is the first study to correlate TSR and MRI findings. STIR and post-contrast dynamic study correlated with the stromal component of breast cancer.

Asunto(s)

Asunto(s)